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It Really Sucks When Somebody Else Claims Your Victory

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Women are the Problem with Women

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The First Day of the Rest of my Life

Yesterday was the end of my career in Display Advertising Product Management.

Today, I woke up a mom, a student, a blogger, a cake business owner, and an activist.  I did all of those things today, and it felt great.  I was more patient with my kids than I normally am.  I felt more invested in my other work.  And I finally felt like I had the time and mental energy to focus on the things that are really important to me.  In the words of the formidable Ice Cube: “Today was a Good Day.”

Plus, my kids slept in until 7:30, woke up in a good mood, and cooperated with me all day.  Julesy did take frightening spill just before lunch time that split his lip wide open and soaked his (and my) clothes with blood.  ACK!  But once he calmed down, it/he was fine, and he ate lunch like it hadn’t even happened.

Then both the kids took a nice, long nap, and so did I.  Pure Heaven.

OH! And the greatest piece of news for the day was that one of my ICAN moms had her baby by VBAC this morning.  I was intensely invested in helping her get her VBAC, and have been laying awake at night worrying about her situation.  Her case was especially nail-biting because her OB actually dropped her at 41 wks pregnant last week (hello unethical!) because she refused to have another cesarean that she felt was not medically indicated.  Her doc told her she was killing her baby, etc., etc.  And today, she proved that doctor wrong by birthing her little girl vaginally without incident. Love it.

Now I will retire to rest up for my big Philosophy midterm tomorrow evening.  I just have to say I'm feeling really good about life right now though.  Yay life... You rule.

Wordless Wednesday

  (find more images at BirthCut.com, Artist: Michelle De Mont)

Breeding With the Enemy: My Story of Feminist Conversion

This is the story of how I went from being a decidedly childless feminist, to a Feminist Breeder, and what that change meant for my conflicted views of the Modern Woman.

I inherited my early feminist views from my non-traditional family.  I had no mom or dad around, so I was raised by grandparents, aunts, and uncles, and sometimes lived on my own for months at a time while the guardians went off to find work in other areas.  I find that horrifying these days; that a child not more than 10 yrs old could be left in another state to feed themselves and get themselves off to school in the morning, but such was my life, and it all seemed normal at the time.  This helped me develop an independence that lays a fertile soil for feminist ideology.

My maternal grandfather was the type of man who wanted his girls to be able to take care of themselves.  Though terribly physically and emotionally abusive (which I now attribute to a lifetime of undiagnosed anxiety and clinical depression), there was a part of him that treated women with far more respect and dignity than most men of his generation.  Women were complex and mysterious creatures to him, though I believe he was sometimes so intimidated he lashed out, and those were the days I got my ass kicked.  My grandmother handled everything of importance, and whatever she wanted she got.  He wanted his daughters (of which I was always considered to be one) to excel and succeed.  He taught me to change the oil in my car so I wouldn’t have to depend on a man to do it.   He tried (in his own way) to raise me with common sense and a good work ethic, so I could make my way in the world.  He raised me like a man raises his son, while still entertaining my need to be a girl sometimes.  I suppose if anyone “taught” me to be a feminist, it was him. 

There were no Stay-At-Home-Moms in my family.  The women in my family worked; not as a matter of politics or choice, but as a matter of survival.  My grandmother worked as a roofer right alongside my grandfather, every day for nearly 40 years.  She didn’t get to stay home with me, even when I would beg her.  Not working meant not eating, though there were many days I went hungry anyway.  We were poverty-stricken, a fact I did not fully realize until I became an adult.

My aunt liked to tell me that “Every woman is only one man away from welfare” – meaning don’t rely on anybody.  My aunt helped raise me when my grandparents couldn’t and she’s as Feminist as a woman can be.  Well, any woman who’s never been a mother, that is. It’s not that she didn’t want babies, she did, desperately, but she was not able conceive, and then re-married to a man who didn’t want them anyway.  She’s Pro-Choice in terms of reproductive freedom yet often refers to pregnant women as “a buncha whiners.”  She has little tolerance for anyone unlike herself, and even less tolerance for women complaining about their girly bits.  She also helped convince me during my first pregnancy that childbirth was "deadly" and “thank god” for that birth rape cesarean or I’d have ended up just like Great-Great Aunt Mable from the old black & white pictures who died during childbirth in the 1910’s.  I had never spent any time around women who discussed birth, and only knew what I saw from shows like "A Baby Story" or "Maternity Ward" so I didn't question any of this.

After the trauma of being gutted like a fish in an operating room with my arms strapped out at my side like Jesus on the cross, convulsing and throwing up all over myself while my husband watched in horror, I started to question my Aunt’s understanding of feminism and politics in general.  If being a feminist meant allowing masked Med-Pros to violate my body, I don’t know if I’m cut out for her feminism after all.

Because of my upbringing, I saw children as a punishment.  I had never seen a planned pregnancy in my family.  The children all seemed to be consequences of a loose, irresponsible woman looking for love in the wrong place.  Nine months later, a welfare case was born.  I decided very early on that I would not be one of those women.  I did not want children.  I didn’t want to be punished.  But if I there ever was a day when I wanted a child, they would be born into a stable family – into wedlock at least – unlike any other child in my family’s sordid history. 

To me, feminism meant avoiding anything and everything that was exclusive to women.  Childbirth seemed oppressive, as did my biology in general, and I wanted no part of it.  As far as I was concerned, it could all be removed and I'd be better off.

When I got accidentally pregnant, I was angry.  Angry at myself for being so stupid, and angry at my (now) husband for wanting me to keep it.  I always assumed two pink lines on pregnancy test would have me out the door to Planned Parenthood for my quickie abortion before the urine dried.  But until I was in that situation, I never could have known how I would end up handling it.

As it turns out, abortion wasn’t an option for me.   Not at that time.  Not in this relationship.  I felt that I just didn’t “qualify.”  While our circumstances at the time were less than ideal for starting a family, I wasn’t a crackhead or a scared teen either.  I had the things I felt were required for accepting the responsibility of a positive pregnancy test: a responsible mate who already asked me to marry him, a place to live, help from our family, a good head on my shoulders, and a healthy body.  And most importantly, I couldn’t do that to him.  He wanted the baby, and I knew that aborting it would kill a part of him that would never recover.  I couldn’t justify terminating a pregnancy simply because I got sloppy one night.  I had made a bed, and the grown-up thing to do was lie in it.  And the fact was, ladies and gentlemen, I wasn’t getting any younger anyway.  Every woman in my family had already finished having babies by the time she was the age I was when I got knocked up.  People in the family had actually begun to assume I was infertile.

Now, people often ask me when I “knew” I wanted to be a mother.  I always have the same answer: “At 7:27 pm, August 1st 2006 – the moment my son was born, and not a minute sooner.”  Even through those nine months of pregnancy, I wasn’t sure I was cut out for this.  I was a feminist, dammit!  I couldn’t be tied down with a child.  I had school to finish and places to travel to.  There were times during the pregnancy that I told my new husband I wanted out, and that I’d give the baby to him and his mother after it was born and they could raise it.  Why not?  That’s what my mother did with me. She wasn’t up for the motherhood stuff, so she left me on doorsteps and took off.  Why would I – should I – be any different?  Well, my mother was/is also a horrible human being and ought to have been chemically castrated before she went on to ruin three more childrens' lives – but that’s a whole other story.

Instead, on that date 3 years ago, I was transformed.  Physically, emotionally, spiritually, mentally – all of it.  The moment I heard my child cry, my brain chemistry changed, and suddenly I realized that being this person’s mother was not a punishment.  On the contrary, it was a gift I probably didn’t deserve, but I would spend the rest of my life trying to deserve it.  Though I was overjoyed by this perfect little miracle I had just produced, I felt sad and robbed that he was cut from my womb, instead of being birthed by me.  I never knew how much that would matter until it was taken from me.  I vowed that my next child would be birthed by his mother – not by a man in a mask.

I started that pregnancy thinking breastfeeding was gross.  I’d never seen it done, but it seemed like it was something white trash women did.  I was clueless.  Then I had my baby, and nurturing him from my breast seemed right.  After all, I had made this little baby in my body - it made sense for me to keep feeding him with the same body that had done such a good job making him.  Unfortunately, thanks to a cesarean and a period of separation, along with little support from my doctors, breastfeeding wasn’t successful for me with my first son.  Once I had to switch to formula feeding, I realized just how oppressive and sexist formula feeding, and formula companies, truly are.  Here you are born with two sources of perfect nutrition right there on your body, and our patriarchal society convinces you that custom-made milk isn’t good enough.  Your body isn’t good enough, and what you’re providing for your baby – without their help – isn’t good enough.  They convince you to enslave yourself (and your wallet) to the formula manufacturer - the buying, mixing, heating, and washing of bottles - all while their product undermines your health and your baby's health.  And they do all this while convincing the vast majority of women that it’s somehow liberating them.  *headshake*

Right then, my feminism changed.  That cesarean, and that formula feeding, taught me that the most feminist thing I could do for myself was to take back my body and my autonomy.  I birthed my second baby through my vagina, and it was the most important thing I’ve ever done in my life.  I made breastfeeding work that second time, and am still nursing my son 15 months later.  I wanted to be an excellent mother and raise my children up to be good people who will become the next generation of feminist freedom fighters. 

Having a uterus and breasts wasn’t oppressive anymore.  My feminine biology was a gift that no man will ever get to experience, and it is my duty to protect the sacred gift which mother nature provided to me – not to shame myself for having it.  

And so, I fight the system, along with all my feminist mothering sisters. 

• I fight for a women’s right to give birth naturally, without the medical community descending on her and compromising her health or autonomy with their (often unnecessary) drugs, instruments, and surgical deliveries.
  
• I fight for women to breastfeed when and where they want without a Puritan, patriarchal society shaming her for her womanly ability to nurture her young.
  
• And I fight for women’s right to be both a mother and a worker, without having to sacrifice her family just to keep a job or get ahead.

This is what feminism means to me now.  And I have my children to thank for this.  They opened my eyes to a world beyond anything I had imagined, while forcing me to eat many of my words.

Thank you children.  Life wouldn't be the same without you.  And knowing what I know now, I would never want it to be.

Trust ME Twitter Friend, You Don't Need That Cesarean

I think many of us walk a fine line between wanting to know what’s going on in the world, and being sorry we ever asked.  Thanks to the power of Twitter, I have been able to cyber-witness mothers everyday in hospitals all over this country being rolled off to the OR for their cesareans – all Tweeted live by the expectant father.  It’s not hard to tell by a quick glance at the blinkies on the side of my blog that I am no fan of cesarean deliveries, and I’m not one to hide my feelings on the matter either. Science and evidence are on my side, and I know it.  I realize this means I’m putting myself in a challenging position by exposing myself to certain Tweets in Twitterland.

Oh, they just make it too easy.  If you have a nifty application like TweetDeck or Seesmic, you can perform a quick search on any word, and it will open a column that is continuously populated with tweets that contain that searched word.  Right now I have a column open for the term “BFing” (or breastfeeding) and one for the term “cesarean.”

Almost every day I see a tweet or two come in from a dad in a delivery room somewhere in America’s heartland, saying something to the effect of “labor’s a bust, we’re going with the cesarean.”  And of course, being who I am, my heart drops just a little.  I can’t not say something (more on this later).  So here is the transcript from yesterday’s encounter:

TheDad: Thank god for the epidural. She's in labor getting close! Exciting!
TheDad: Doing cesarean in bout half an hour after no progress from baby with 2 hours of pushing

(Here's where I come in)

Me: Get rid of the epidural, and she probably won't need the cesarean (they r bad news). Seriously. That's what worked for me.

TheDad: it's only bad whentoo strong to feel anything. Babies head toobig nothing to do with epidural

Me: it's bad when she can't move to reposition the baby. If she was able to move, baby's head is likely to fit. Avoid cesarean.
Me: and btw, "big baby" and "big head" are good excuses for docs to cut, and 90% of the time they are wrong about size.

TheDad: of course she can move to reposition the baby. Epi doesn't mean handicapped. It's not rocket science. Some heads are too

TheDad: big and some hip bones are too small and don't move.

Me: i'm a small woman who birthed a 10 lb baby after the doctors said I never could. Doctors love cesareans. Very sad.

TheDad: great for you. Unfortunatelynot all womens bones cooperate

Me: we always blame the woman's body. Our bodies are not a lemon. Good luck with baby, I wish Mom a speedy recovery. Ican-online.org

Now, I realize that it seems completely ludicrous that I would expect some stranger to take my advice over Twitter.  I am under no delusion that this man is going to turn to his wife whilst she’s being prepped for the OR and say “Honey, unplug the spinal, this woman on Twitter says you shouldn’t have a cesarean.”  And I’d surely die of shock if she actually turned to him and said “Really?  A stranger on Twitter said so? Okay, unhook me Doc! I’m delivering this baby through my vagina instead.”

No, no, it’s not like I really think that’s going to happen. So why do I bother?  Why do I upset myself, and undoubtedly upset this expecting dad on the most important day of his whole life?  I promise this is not nearly as selfish as it sounds.  Or at least I hope not. 

Yes, I understand that I don’t know any of the details about this couple’s unique situation.  Maybe there was a really, really good reason why she needed a surgical delivery.  The issue is, though, this situation is hardly “unique.”  If people only knew how their cesareans played out like scripted screenplays, they might feel cheated and lied to.  The Business of Being Born did an excellent job of creating a cartoon out of this all-too-common situation.    Everyone thinks their cesarean was “necessary” and an “emergency” when in reality so few of them really are.  I want people to know this. I want to help them avoid this.  I want them to avoid the pain and trauma my cesarean caused me. 

My intentions are pure – but you know what they say about Intentions and that Paved Road to Hell…  The truth is, I can’t help it.  I have always felt some unshakeable urge to convince others of my argument, especially that which I am passionate about, even if it may not be the appropriate time or place for such an exchange.

Ten years ago I wrote and recorded a song called “The Joke’s On You” in which I announced to a (then) unrequited* love that:

I have two things
A big mouth, and bad timing
But I have something
You can’t admit that you need
Oh, oh, oh, the joke’s on you.

It seems not a lot has changed in the last ten years.  I’m a different person, arguing about different things, but my need to be right, and/or save people from certain doom (whether that be a major surgery, or the sin of not loving me back) hasn’t shifted much.  And now that I think about it, I may have been like this since I was a child.

I once held a sleepover in 7th grade.  You know, the kind that you invite all the popular girls to in an effort to improve your social status.  For some reason these sleepovers always consisted of a crying session, in which girls would sit in a circle and take turns telling some tear-jerking tale. We would all sob and hug each other – the general purpose being that all this emotion-sharing would bond us, like, 4-ever.

I remember at this particular party, one girl, let’s call her “Lydia”, used her turn to tell the story of her uncle who was dying from cancer.  Very sad indeed.  Everybody loaded onto the Sympathy Train and listened intently to Lydia’s sad story.  She came to a point where she told us all that she visited her uncle in the hospital, and he had lost all his hair.  Lydia informed us that the cancer had made him bald.

I looked at Lydia with the typical level of care and concern that an 11 yr old girl is capable of, and proceeded to correct her.  “No Lydia,” I said, “the cancer itself didn’t make your uncle lose his hair, it was the chemotherapy – the treatment for the cancer that did that.”  Big Mouth.  Bad Timing.  Even at 11 yrs old.

Lydia screws up her face and shouts back at me “No! It was the cancer! He said so!” and wails a little harder.  All the other girls rush in to hug her, glancing over their shoulders at me with daggers in their eyes, like I’m the biggest dickhead in the whole world.  They think to themselves, “Ughgh, there goes Gina again, being an argumentative ass. It’s no wonder none of us really likes her.  We only came to this sleepover because she promised that there was an old liter of vodka stashed in the back of her grandparents cupboard.” 

What?  I was right about the Chemo.  But I guess that’s no excuse for saying so.

I don’t know.  Perhaps I am a dickhead.  Perhaps my habitual urge to explain the truth to others indicates that I harbor some clinical form of narcissism that could benefit from a little old-fashioned shock therapy.

I prefer to believe that I am a Defender of The Truth.  I think this is what will make me a great lawyer.  If I wasn’t willing to take one for the team, how could I ever help anybody?  I suppose it is my destiny in life to be a little bit hated by some, but appreciated by those souls I can actually get through to.  I may not have saved that woman from her cesarean, but maybe I planted a seed?  I hope, very very hard, that’s what happened.

Though most days I think I ought to delete the columns from Tweetdeck, and surgically remove the part of my soul that aches from these un-truths. 

It is just so much simpler not to care.

~TFB

_______________________________________________

*We went on to date for two years, and are still very good friends.  That relationship remains one of the most important relationships either one of us has had to date. See?  I was right.

Things You Should Read Thursday, Vol. 10

Thanks to some very high profile articles, Natural Birth is having The Best Week Ever. In case you spent the week under general anesthesia, here’s what you missed:

Heather Armstrong (Dooce.com): The Labor Story, Part One
Here, arguably one of the most famous blogging moms in history, tells the story of how she went from being a “give-me-the-epidural-two-days-ahead-of-time” type of mother, to being radically transformed into a Natural Birthing Evangelist, just 10 weeks before her second baby was due.  She credits a free copy of “Your Best Birth” for changing her mind.  Go Ricki & Abby.

Unnecesarean.com: “Pit to Distress: Your Ticket to an ‘Emergency’ Cesarean?”
In a word? Horrifying.  In another word? Familiar.  Here the lid is blown off a common procedure being performed in maternity wards every single day where doctors and nurses knowingly use Pitocin to inflict stress on a fetus, all so they can call for an “emergency” cesarean.  No.  I’m not kidding.  It’s very real. I would argue that it’s exactly how I ended up with my cesarean. 

And on the same topic…

Cate Nelson: “Leash This Pit”
More on the harmful use of Pitocin, and the “medicalization” of childbirth in general.  Cate talks about some alternatives to artificial induction, and calls out the dangers and misconceptions of chemical inductions.

Now in mainstream birth news – there go those silly politicians again, spinning the facts and undermining health care…

Louise Marie Roth: Dick Morris Doesn't Understand Birth or Health Care
I just love when men who have zero experience with birthing talk about birth choices as though they themselves might be personally affected. Here, Roth calls out former Clinton advisor-turned-criticizer, Dick Morris, for accusing the Obama administration of forcing women to sacrifice their health by having natural births.  Huh boy.

And finally (as though the previous things weren’t enough to chew on for the week)

(VIDEO) Bill Moyer’s Journal: Interview with former CIGNA VP, Wendell Potter
If this doesn’t blow your mind, I don’t know what will.  Here the head of an insurance company reveals how his moral epiphany led him to resign from his posh job, and has him now speaking out about the amoral practices of both the large insurance companies, and the politicians who try to oppose universal healthcare.  He admits that Michael Moore’s documentary Sicko “hit the nail on the head” and that our country’s healthcare is in crisis.  After this, nobody has any great excuse for believing the bull the insurance companies and Republican supporters try to sell us.

Okay, you’ve got your hands full now.  Enjoy!

Things You Should Read Thursday: Vol. 9

This week – lots of news in the world of natural birthing and breastfeeding!

C-sections shouldn't be 'automatic' for breech births, Canadian doctors say
So, the Society of Obstetricians and Gynecologists in Canada has decided that vaginal birth is a perfectly reasonable option for delivering most breech babies, and they’ve even go so far as to begin a program to train doctors in the lost art of breech delivery.  I have to say, I’m dumbfounded.  This is one of the most responsible and intelligent things I’ve heard a medical profession do.  You mean, they weighed the evidence, and changed their mind?  What a concept!  Hey ACOG, take notes from our friends to the north.

Speaking of those smart(er) Canadian doctors…

C-sections, forceps use rising too sharply in Canada, medical groups say
Here several Canadian medical groups complain of the overuse of cesarean, forcep and vacuum assisted delivery, and delivery before 41 weeks.   “Doctors should only resort to these interventions when there is a valid, evidence-based reason” the article says.  Oh, Canada!

But, I do have to throw the ACOG a bone this week – or rather, I suppose it’s them throwing us a bone…

ACOG Refines Fetal Heart Rate Monitoring Guidelines
Finally, the ACOG realizes that fetal heart rate monitoring has done absolutely nothing to reduce perinatal mortality or the risk of cerebral palsy.  In fact, they say that the cerebral palsy rate has remained exactly the same for the last 60 years despite all the interventions and technology thrown at it.  I’ll be sending this to my doctor who (as you may have read in my VBAC birth story) insisted that the heart rate monitor was telling him my child would be born with cerebral palsy if I did not let him perform a cesarean on me.  Idjit.

In other news...

Breastfeeding Improves IQ
Well, it has been argued time and again.  People have said there’s no validity in the notion that breastfeeding makes you smarter, but now there’s been a new study published in the American Journal of Clinical Nutrition that compared the IQs of siblings in the same family, one who was breastfed, and the other who was formula fed.  Guess who came out on top?  Well... I don’t want to give it away, so make with the clicky-click on the link above.

And finally...

And in reference to my Things You Should Read Thursday: Vol. 7 - I'd like to say THIS is the right way for establishments to use the International Breastfeeding Symbol.  Take note.  And thank you Elita @Blacktating for bringing that pic to my attention.  I'd also like to note that the pictures I complained about on the Mothering site have now been removed - I only noticed because I clicked on the link in my post, and it's dead now.  Coincidence?  Or they did hear me (us)?  I find it very interesting, but however it happened, I'm quite pleased.  They now have a page listing the "suggested use" of the symbol, and make particular reference to the symbol not being used to "segregate" breastfeeding mothers (wasn't that the word so many of us used when griping about this?)  Even if it had nothing to do with our complaints, lets all pat ourselves on the back for making a difference anyway.

That's all for now. Toodles!

AMA - a.k.a. Unethical Hypocrites Association

The American Medical Assocation has lost their damn mind.  And this time it affects every single person in this country.  You all should be horrified and frightened.

Tuesday, June 16th, the AMA votes on a resolution to create billing codes that would identify "non-compliant" patients.  What this is means is anytime you do not agree with a doctor's diagnosis, if you seek a second opinion, or if you pursue alternative forms of treatment, this doctor can tag your medical records with a code that labels you a "Problem Patient" - paving the way for insurance carriers to deny you coverage.

The entire concept of this is not only totally against the doctrine of informed refusal, but is also completely hypocritical to the American Medical Association's OWN codes of conduct for Informed Consent & Refusal.  The following is taken directly from the AMA's own website:

Informed consent is more than simply getting a patient to sign a written consent form. It is a process of communication between a patient and physician that results in the patient's authorization or agreement to undergo a specific medical intervention.

In the communications process, you, as the physician providing or performing the treatment and/or procedure (not a delegated representative), should disclose and discuss with your patient:

• The patient's diagnosis, if known;
• The nature and purpose of a proposed treatment or procedure;
• The risks and benefits of a proposed treatment or procedure;
• Alternatives (regardless of their cost or the extent to which the treatment options are covered by health insurance);
• The risks and benefits of the alternative treatment or procedure; and
• The risks and benefits of not receiving or undergoing a treatment or procedure.

In turn, your patient should have an opportunity to ask questions to elicit a better understanding of the treatment or procedure, so that he or she can make an informed decision to proceed or to refuse a particular course of medical intervention.

So, hold on.  Informed consent and refusal is not only protected by every level of law that exists in this land, but it is also advocated right on the AMA's own website, and now they think they can pass a resolution to punish anyone who invokes their right to participate in their own care? 

Besides the obvious implications this has on VBACing mothers, it's obvious that no healthcare-seeking American would be safe from this ridiculous resolution.

So, what can you do about it?  Well, you can act really quick - ICAN has posted a list of resources you can contact to voice your opposition to this.

_____

UPDATE! The AMA voted and the resolution was unanimously DEFEATED!  I'm sure this is thanks to all the hardwork of everyone who spoke out against this ridiculous resolution.  Let's keep an eye on this and make sure they try a stunt like this again!

Things You Should Read Thursday: Vol. 8

(I skipped doing this last week because I had too much to say about the Jon & Kate situation.)

Michael Woodhead: "Natural" caesareans a gimmick
It’s a really short article but it does link to a great PDF.  Right now I’m shuddering at the newly-coined term “Natural Cesareans.”  I knew this was coming.  With the VBAC-lash hospitals have been facing, they’re trying to find ways to convince unsuspecting mothers that major abdominal surgery can somehow be just the same as the real thing.  Doesn’t this sound familiar?  Sounds like Similac saying “The closest thing to breastmilk!”   Yeah. Nice try.  Now, I’m all for humanizing the cesarean process for those women who absolutely must have those surgeries. The experience is already humiliating and traumatizing enough.  Things like keeping the mother with the baby throughout the entire delivery/recovery/postpartum, and allowing breastfeeding immediately, could help eliminate some trauma a mother experiences when, as a result of a surgical delivery, her baby is taken away from her and not seen until hours later.  But does that make it “natural” and the same as vaginal birth?  Absolutely not.

CIMS: Free Web Seminar on Informed Consent & Refusal in Maternity Care
This is geared toward childbirth professionals, but I think anyone interested in these topics should sign up for this free information session. Just head to the website, register for the webinar, and stick the reminder on your calendar. 

That’s all for this week.  Toodles.

A Cesarean Consent Form for the OB to Sign

The following consent form was developed by a mother* after repeatedly being denied VBAC care by the Obsetricians in her area.  This woman's brilliance and tenacity astounds me.  Would your OB think differently if he/she were on the receiving end of one of these consent forms?  Very likely.

I, the undersigned physician, have, in violation of the Consumer Bill of Rights and Responsibilities, the Emergency Medical Treatment and Active Labor Act, the Patient Self Determination Act, the ethical guidelines of the American Medical Association and the American College of Obstetricians and Gynecologists, Constitutional Law (the right to privacy and self determination protected by the 1st and 14th amendments), international tort law, and case law (of particular interest "In re A.C.", 1987, "In re Fetus Brown, 689 N.E.2d 397, 400 (Ill. App. Ct. 1997)", and "In re Baby Boy Doe, 632 N.E.2d 326 (Ill. App. Ct. 1994)") and the Patient Rights as determined by this institution, deprived my client,________________, of her right to self determination and her right to bodily integrity by ignoring her repeated refusal for delivery by repeat cesarean section. I acknowledge that by refusing to honor my client's denial of consent, I have not only violated the above laws, but I also affirm that I have used unwarranted and unethical pressure including emotional threats to my client's and her unborn child's life and safety, in my attempts to obtain such consent. I further affirm that I have stressed the risks of vaginal birth after cesarean, but neglected to inform my patient of the risks of delivery by repeat cesarean section. I further affirm that I understand, that should I resort to physical force, including but not limited to physical or chemical restraints, to compel my client's cooperation, I will be guilty of criminal battery, which is defined as "any form of non-consensual touching or treatment that occurs in a medical setting".

In compensation for the above violations of my client's rights, I hereby guarantee the following:

• a healthy baby, born in perfect condition, with no physical, mental or developmental defecits whatsoever, whether arising from surgery or any other cause

• no complications for the infant, including but not limited to: persistent pulmonary hypertension, transient tachypnea of the newborn, respiratory distress syndrome, iatrogenic prematurity, lacerations, or hematoma

• a speedy, uncomplicated post-operative recovery for my client. Specifically, I guarantee that my client shall not experience nerve damage, organ damage, hemorrhage (whether sufficient to require transfusion or not), disability or disfigurement, intraoperative or postoperative infection of the wound or surrounding skin and tissues, post partum depression and post partum post traumatic stress disorder (PTSD), and other conditions not listed here.

Signed,

_______________________________________________

*with a blessing from the author, please feel free to use, distribute, or copy this form with the instructions below

For internet posts please link back to the author here: http://gisellestotalwasteofbandwidth.blogspot.com/2009/05/different-kind-of-consent-form.html

For use in the classroom setting or other print-out, please credit "T.G. Perg".

And don't forget to leave plenty of kudos and Thank You's in the comments section below for the author of this brilliant consent form.

New Study: Repeat Cesarean Twice as Dangerous for Baby

This time, the news is coming from the June issue of Obstetrics & Gynecology.  Now the surgeons performing the cesareans are aware of the risk.  Now they can't act like they don't know.

But they probably still will.  There have been at least a dozen articles so far in 2009 that list major risks for cesarean delivery.  What will it take before things change?

Here's the article as it appeared on Yahoo News this week.

Risk to Baby Rises With Repeat C-Sections
By Kathleen Doheny
HealthDay Reporter by Kathleen Doheny
healthday Reporter
Thu May 21, 11:49 pm ET
 
THURSDAY, May 21 (HealthDay News) -- Babies delivered by elective, repeat cesarean section delivery are nearly twice as likely to be admitted to the neonatal intensive care unit (NICU) than those born vaginally after the mother has previously had a c-section, a new study finds.

These c-section babies are also more likely to have breathing problems requiring supplemental oxygen, the researchers say.

"In addition, the cost of the birth for both mother and infant was more expensive in the elective repeat c-section group compared to the vaginal birth after c-section (VBAC) group," noted Dr. Beena Kamath, the study's lead author and a clinical instructor of pediatrics at the University of Colorado School of Medicine, Denver.

The study appears in the June issue of Obstetrics & Gynecology.

Nationwide, the c-section delivery rate keeps rising. According to the study authors, by 2006, 31.1 percent of deliveries in the United States were done this way.

Furthermore, women who have delivered once by c-section have a greater than 90 percent chance of undergoing another, the authors noted. But experts continue to debate whether these women should try labor and vaginal delivery, or automatically undergo another c-section, as there are risks are associated with each method.

To help clarify those risks, Kamath and her colleagues turned to records from the perinatal database at the University of Colorado Denver. Those records ran from late 2005 through mid-2008 and focused on babies born to 343 women who had planned a repeat, elective c-section and another 329 who planned to try vaginal birth after having previously had a baby via c-section.

The researchers looked at the differences between groups in newborn admissions to the neonatal ICU and the need for oxygen for breathing problems, as well as cost differences.

Kamath's team further divided the women into four groups. Of the 343 repeat c-sections, 104 went into labor before the c-section and 239 did not. Of the 329 women who attempted vaginal delivery, 85 failed (for various reasons) and went on to have a c-section.

Kamath's team found that 9.3 percent of the c-section babies were admitted to the NICU, but just 4.9 percent of the vaginally delivered babies were. And while 41.5 percent of the c-section babies required oxygen in the delivery room, 23.2 percent of the vaginally delivered babies did. After NICU admission, 5.8 percent of the c-section babies needed the oxygen compared to 2.4 percent of the vaginally delivered babies.

The median hospital stay was three days for babies who were delivered vaginally and four days for the other three groups. Total costs for the c-section group averaged $8,268; for the vaginal group, $6,647.

"The failed VBAC babies required the most resuscitation and had the most expensive total birth experience," Kamath concluded. But, overall, the VBAC group did better than the c-section group in terms of hospital stay and other measures, she said.

Women who opt for a repeat c-section should first understand these risks and differences before they make their decision, Kamath said.

The study results suggest another important take-home point, according to Dr. Alan Fleischman, senior vice president and medical director for the March of Dimes, based in White Plains, N.Y. "The decision to have your first c-section is very important," he said. "There should be a clear medical indication [because] your first may dictate subsequent [delivery methods]."

Women also need to know that vaginal delivery is possible for many women who have already undergone a c-section, Fleischman said. Some hospitals do not allow vaginal delivery after a prior c-section, however, so he suggested that any woman who is planning on one find out early on what her hospital's policy is.

In the same issue of the journal, other researchers found that the chance of a pregnant woman having a hypertensive disorder -- such as high blood pressure that first occurs during the pregnancy -- has risen greatly in recent years, from about 67 per every 1,000 deliveries in 1998 to more than 81 per 1,000 deliveries in 2006.

This increase, in turn, is boosting the number of hospitalizations associated with health problems in the mother-to-be, such as kidney failure or breathing problems, according to researchers at the U.S. Centers for Disease Control and Prevention.

I'm going to start a folder of these printed articles, and show that to any provider who would attempt to deny me a VBAC.  I'd suggest any mom going for a VBAC do the same.  Considering that my sOB treated me like a silly child when I told him I'd done my homework on VBAC and the risk of repeat cesarean, obviously he'll need to hear it from his own people.

Things You Should Read Thursday: Vol. 7

This week, something to read, and something just to look at.

Lisa Girion - Childbirth: Can the U.S. improve?
Such an wonderfully rich article on the cesarean plague facing this country.  Most articles like this (and there have been quite a few lately) seem to take the luke-warm, way-too-diplomatic approach.  This article offers the unabashed truth, and it even contains quotes from doctors finally waking up and smelling the post-operative stench.  Perhaps change is afoot?  And with the medical professionals finally admitting that there is a disturbing cesarean rate in this country, I would just like to offer a hearty “I freaking told you so” to those who didn’t believe me.  I can only hope that the insurance companies and legislators listen to these doctors.

Is this really Breastfeeding Support?  Why I think this is a big Mothering Magazine Fail.
Based on the crickets I heard when I brought this issue up on Twitter, I have deduced that either I’m reading too much into this, or none of the folks in my circle of naturalists would dare say a bad word against their precious Mothering Magazine.  But these photos tell a totally hypocritical story to me.  This is a page dedicated to photos of the official international breastfeeding symbol being used to denote “breastfeeding friendly” establishments.  So, there’s a symbol in a restaurant window.  Awesome.  And there’s a symbol framed on a fancy luncheon table.  Super.  Wonderful use of the symbol.

But, the symbol posted on the door of a “Mother’s Room” in an airport, with the caption “To obtain key, please see the Travelers Assistance Booth across from Gate C12” – yeah, not a great use of that symbol if you ask me.  So, what this sign is REALLY saying is “No, you should not be breastfeeding wherever it is convenient for you. Instead, you need to drag your baby to Gate C12, wherever that is, and get a key to enter this room so you can hide away that dirty, dirty breastfeeding you plan on doing.”  If I were the owner of the breastfeeding symbol, this is NOT how I would want it used.  There are also several other photos of the symbol being used to denote a nursing station of some kind.

Perhaps I’m overreacting, but I see this as a Mothering Magazine fail.  They’re congratulating facilities that use the breastfeeding symbol to relegate women to makeshift bathrooms and other hiding places, instead of using the symbol to demonstrate that breastfeeding mothers are free to nurse wherever they choose.  Eh.  It just chaps my hide a bit.  Please, tell me your thoughts on this.

That’s all for this week.  Enjoy!

The One Year Anniversary of My VBAC

Today, May 16th 2009, is the one year anniversary of my successful VBAC.  For those of you who went on that journey with me, you’re probably just as surprised as I am that it has been an entire year since those events.  It seems like just yesterday.  Many of you have had your own successful VBAC stories in that time, and for that I am so proud and thankful.

Last year, on this day, I was hooked to machines, screaming at doctors, and begging not to be gutted like a fish for the second time.  Though that day started out being the worst day of my life, at 10:01 pm, it became one of the 3 best and most important days of my life -- because at that moment, I pushed my son out of my body.  Nothing in the world can describe how important that moment is, and most people will never understand why that moment meant so much to me.  I birthed a baby.  Finally.  And no matter what I do for the rest of my life, that will forever be the moment I am most proud of.  That will go down in my history as the All-Time Most Mind-Blowing Moment of all.

So my VBAC baby is One today.  Happy Birthday Jules.  Thank you for everything that you have been to me.  Your Father, Brother, and Mommy love you more than words can ever say.

Mommy Guilt - It's all about Perspective

There has been a particularly large volume of anti-lactivist articles and blogs surfacing lately, and I’m trying to make sense of them.  It seems that every mother who formula feeds feels the need to lash out against the women who told her she could/should breastfeed.  It goes the other way too.  Those of us who needed support breastfeeding, and only had formula feeding shoved in our face, are equally as pissed off about the things we were told – even if the person promoting formula feeding was just trying to help.  Perhaps they saw a stressed out mom and thought “Jeez honey, why are you doing this to yourself? … give the kid some Similac and call it a day … you’ll be much happier.” – not knowing that they were unintentionally slapping that woman’s breastfeeding efforts across the face.

It’s not just with breastfeeding though.  This is a strong phenomena in all aspects of natural birthing and mothering.  Some who’ve had c-sections get offended when women talk about natural childbirth.  They loved their c-sections and thought they were necessary, so shut-up-you-stupid-hippy-with-your-stupid-painful-natural-childbirth-nonsense.  And those who are traumatized by their medicated or cesarean births are offended when someone says “It doesn’t matter how the baby came out.”  That’s another big slap in the face.  Those are the kinds of statements that exacerbate the post-partum depression and post-traumatic stress disorder caused by that woman’s traumatic birth experience.  But the person’s intention is to help, so how can you fault them?

Well, as they say, the road to hell is paved with good intentions.

A friend/family member/provider can make a comment, and depending on the mother’s perspective, that comment can be taken a number of different ways.  That comment can be seen differently even by the same mother depending on what mood or mind frame she is in.

Example:

Setting: My 1st Pregnancy, 1st prenatal appointment

Midwife: are you going to breastfeed?
Me: Hell No!
Midwife:  Why not?
Me: Because that’s disgusting!
Midwife: You really should think about breastfeeding, here is some information.

(later, to my formula feeding friend)

Me: That midwife was so f*cking mean!!  She practically held me down and forced me to say I would breastfeed!
My Friend: Yuck! I didn’t breastfeed, and you don’t have to either
Me: Thank you, you’re such a good friend!

Fast forward 2 and a half years...

Setting: Pediatrician’s Office – 2nd baby’s 1 week postnatal checkup

Pediatrician: He hasn’t regained his birth weight yet
Me: So? He was born nearly 10 lbs
Pediatrician: Well, we should give him some formula too, just for now
Me: Um, no, that ruined my breastfeeding relationship the first time, I’m not doing that route again
Pediatrician: But I’m really worried about his slow weight gain

(later, to my breastfeeding friends)

Me: That stupid Pediatrician tried to tell me I’m starving my baby!
My Friend: They don’t know what they’re talking about – see, here’s some information – keep breastfeeding, you’re doing great
Me: Thank you, you’re such a good friend.

Do you see what I mean?  I am the same person, just with a different perspective, and that perspective paints each of my interactions with a very different brush.  Was that first midwife forcing me to breastfeed?  No. Was that pediatrician forcing me to formula feed?  No.  But what I heard them say was determined by my OWN feelings about the situation.

So, if you’re feeling guilty over formula-feeding, why not take a step back and determine *why* you feel guilty.  Did that lactation consultant really call you a "shitty mother" because you made the informed decision to quit breastfeeding?  Or is that just what you heard?  No one can make you feel something unless you let them, so if you’re feeling guilty, perhaps you have deeper feelings about breastfeeding or formula feeding than you’d like to admit?  And if you don’t, then you should be happy with your decision – plain and simple.  No one has the ability to go into your head and force your brain to transmit guilt into your soul.  Guilt is self-inflicted.  It’s your conscience telling your brain to consider this decision with care because this one really matters to you.

How about we all put these "wars" into perspective and realize that happiness comes from within.  Make your decision, with information, please, and then be happy with the path you’ve chosen.  If someone has a different opinion, take it for what it is – an opinion – and don’t internalize the chatter unless what they're saying helps support your informed decision.

Then, none of us have anyone to blame for our Mommy Guilt except ourselves.

Things You Should Read Thursday: Vol. 3

I’m drowning in things to get done so today’s list will be short and sweet.

Jennifer Block:  “The Backlash to Breast is Best; Why exactly is breastfeeding under attack?”
Yet another rebuttal to the now infamous Rosin article, but I think Jennifer has said it better than most.  A good read.

Amity Reed: “Not a Happy Birthday”
Long before I had ever heard the term “BirthRape,” I felt like what happened to me during my cesarean was definitely a form of rape.  It was traumatizing beyond all explanation, and it all just felt very, very wrong.  Now the term has grown in popularity, and Reed’s article does an excellent job of explaining it to those who may not understand how women like myself can apply such an ugly word to such an otherwise beautiful thing.

Those two articles are heavily substantive.  Away, be gone now, to soak them in.

Things You Should Read Thursday: Vol. 2

First Up: A Birth Story

"My Big Ugly VBAC: It Wasn’t Pretty, But it Was All Mine"
This is not just a birth story, but an entire website dedicated to this woman’s no-holds-barred account of her VBAC which, despite everything, she says was “worth a million words, truly.”  I relate to the way she describes her cesarean and HBAC being like night and day, and how healing the VBAC was for her.   She battled her own fears and seemingly endless labor pains to have her baby just how she needed to: at home, surrounded by her family. 

Next Up: More Unnecessary C-Sections in the News

"Doctor Won't Make The Cut: Feeling pressure from hospital for more c-sections, she leaves"
This self-proclaimed “midwife with a MD behind (her) name” left the hospital she practiced at after they tried to force her to increase her 10% c-section rate to more than 20% without any medical justification whatsoever.  Unfortunately this article is four years old, which means that little has changed.

Last Up: Unassisted Birth Goes Wrong (And This Article Goes Even Worse)

Jessica Gottlieb: How Safe Is Your Home Birth?
Gottlieb writes a malicious article on tragic results of Janet Fraser’s unassisted home birth in March.  She considers her a “criminal” for needing to have her child at home, and dismisses Janet’s term “Birthrape” as being “much more important to Janet than the safety of her child.”  Suffice to say I left a nice, ripe comment.

Happy Reading!

"Things You Should Read" Thursday

This will be the first in a series of weekly installments I am dubbing "Things You Should Read Thursday" in which I post the stories and articles of the week that made my heart go pitter-patter.

First Up - A Birth Story:

HBA2C, 45+ Weeks gestation, 11 lb, 12 oz baby
This mother chose an HBA2C after her the local doctors and hospitals refused to let her try a VBAC or a gentler cesarean (not being separated from baby, etc.)  She also had a "T" incision with one of her cesareans.  She went 5 weeks post dates, and delivered a (nearly) 12 lb baby without so much as a single tear. (thank you to Unnecesarean for finding this one.)

Next Up - I know many of you are probably sick of hearing about Hannah Rosin's article, but I personally enjoy every tongue-lashing she receives over it - particularly those from the important or influential.  I admit that I sadistically revel in the beating of a dead horse, until it rolls over and admits that it was wrong. (And for those of you wearing tight panties, no, I am not calling Rosin a horse anymore than Obama was calling Palin a pig.  Umm.. Err... Ahem.)  Either way, I will continue to denounce this article until The Atlantic, GMA, and Rosin herself come forward issue retractions, and apologize for all they've done to undermine mothers and breastfeeding. 

And I get by with a little help from my smart friends...

Peggy O'Mara: Case Closed, Breast is Best
Peggy writes a compelling piece on the facts, and tells Rosin "Slandering breastfeeding because our society makes it inconvenient is like vacillating on equal pay for women because it's difficult to achieve."  Go Peggy.

Kimya Dawson: The Case FOR Breastfeeding
Before several Twitter friends directed me to this article, I had never heard of this singer/songwriter.  I can't keep up with what the kids are listening to these days.  But reading this article actually made my milk let down. This artist's song was used without permission by Rosin in her podcast, and when the artist (who also hated Rosin's article) found out, the gloves came off.  I want to hug her.

Go forth and enjoy these quality pieces of writing.

Feminism is Not my Religion

Some feminists claim that feminism is about supporting other women's choices unconditionally and without judgment. I disagree wholeheartedly.
 
I believe feminism is about equality.  Nothing less.  Nothing more.  I do not believe feminism requires supporting any choice a woman makes regardless of its context or consequence. The blind support of a person or action based solely a shared ideology, without critical thought, is nothing more than a religion.  Or... some might call it a cult.

Great feminists have defined feminism time and again:

"Feminism is the radical notion that women are human beings"
~Cheris Kramerae, author of A Feminist Dictionary, 1996.

"Feminism is the advocacy of political, economic and social equality between women and men."
~Feminist Majority Foundation

"A feminist is anyone who recognizes the equality and full humanity of women and men."
~Gloria Steinem, founder of Ms. Magazine, leader of the Women's Movement.

Nowhere in those three statements does it say “Feminism is about limitless choice.” I do not believe Feminism is simply about “choice” though it can sometimes be about the right to make certain choices, especially choices that support equality.  However, if those choices undermine equality for every woman, good luck getting support from me. 

A good example of a real choice: the choice between working or staying home.  Both have risks and benefits, and no science has ever proven that one is universally better than the other.  It’s about what works for you and your family.  Neither one is more feminist than the other.  Neither decision undermines equality or our gender.

Another good example of choice: the right to carry, or terminate, an unwanted pregnancy.  What is right for that woman depends entirely on her own circumstances and capabilities.  No one will ever know if she would have been better off taking a different path (though I openly admit that I loathe abortion and decided against one for myself.)  I will always support choice in this area.

But, do you really believe every woman’s every “choice” should be supported?  Tell me you’ve never seen a woman, 9-months pregnant, sucking on a Marlboro Red, and thought to yourself “Oh my god, that is disgusting!”  Is it her choice to choke her unborn fetus with cigarette smoke?  Sure it is!  Do you support that choice?  Are you going to walk up to her and say “Way to go!  Smoke another one for me!”  I bet you a thousand dollars you won’t.  You judge it, just like I do, and don't try to tell me you don't.  It is repulsive, and it’s okay to say that.  Several states have laws against smoking in a car with children in it.  This is a good case of legislating parenting.  Smoking itself isn't illegal, but being a bad parent can be.  Some things clearly undermine public health and our society, and I’ll be the first to say so regardless if a man is doing it or a woman is doing it.  I will not support some things, and feminism (a.k.a. gender equality) does not require me to.

The other problem with calling everything a “choice” is that it reduces anything we are to being simply a personal choice.  All the sudden, just being a woman is now a "choice" that is open to debate and possibly legislation by others.  It has already happened with birthing and breastfeeding – two things that are completely owned by women, and yet are continually being snuffed out by the Cash Cow Corporations whose vested interest lies in pushing c-sections and formula.  And the best part of that?  They convince you they’ve done you a favor!  You’ve been “liberated” by being chained to The Man.  Nice going.

I am a female mammal; vaginal birth is not a choice, rather, it is the way nature designed my child to be birthed from my body - a design that even our modern scientific research has proven to be the healthiest possible way for a baby to be born.*  Why?  Because it does not require new-fangled technology.  It is natural.

I am a female mammal; breastfeeding is not a choice.  It is how our offspring was meant to be fed - an act that modern scientists and economists have proven is the best possible way to feed our babies.* Why? Because it does not require new-fangled, chemically comprised mystery liquids.  It is natural.

But calling these things “choices” leaves the opportunity for others to say that you could have made an “alternate choice” -- and because you didn’t, you should suffer the sacrifices of that “choice” and not look for any special considerations.  And this opens the door for discriminating against mothers simply for being mothers – which is the one basic biological function that is exclusive to the female gender.

Let me illustrate.  Our country says you are allowed the freedom to pray to whatever God you want.  To truly honor that freedom, we must allow or citizens to recognize their religion in whatever way they believe is necessary, and we all work around it.  But what if, by the same stroke, those who recognized Yom Kippur, for example, were told it was their “choice” to be Jewish, therefore they were not allowed a day off work to recognize the holiday?  That’s not equality.  You cannot claim to be equal if you are still being punished for what you are.

Equality does not mean “sameness.”  Equality does not mean trading off your feminine biology to become a pseudo man.  Equality means taking us for what we are; and that includes the accommodations that must be made to allow mothers to mother the next generation of people the best way possible.

But let’s take this in another direction.  Do you hear MEN typing around the blogosphere about how they should support all choices other men make?  When a man does something against nature and intelligent evidence, do you hear other men chiming in saying “Hey man, being a man is about choice!”  No, you don’t.  And you don’t hear them criticizing and undermining each other because of the very things that make them male.  In fact, anything that is inherently male is usually celebrated and protected.  They don’t tell each other they should cut off their manhood to be “equal” and sell that manhood to corporations and special interest groups to be “free” from their male-ness.  They’re not looking for an escape hatch.  And they’re not apologetic about what they are.  And most importantly, they don’t claim that civil equality requires them all to hold hands and agree with every choice every one of them makes.

If you want equality, then allow female brains to think critically and make sound judgments about issues facing our society – just like men have been doing, unapologetically, since the beginning of time.

You do what you want, and I’ll reserve the right to agree or disagree with it.  If what you’re doing is universally questionable, I’ll disagree loudly with it.  And at no point in time will I ever feel like I am under some obligation to support you because we share a chromosome.

My only obligation, as a card-carrying feminist, is to support and advocate for that which promotes gender equality.  That is all.

_____________________________________

*clearly I mean in normal, healthy situations. There are exceptions to everything in this universe.

Article: Complications Blamed on Cesareans

So, the research shows an obvious correlation between rising rates of childbirth complications alongside rising rates of cesarean deliveries.

Well, duh.

But I'm happy that someone wrote an article (albeit a too-short, poorly interviewed article) to highlight this disturbing trend.  But the doctors say "some women prefer a Caesarean because they view it as easier..."

Hold on.  Which women?  I know there are some women like this, but the majority of us would rather NOT be cut into.  Here we go again with the blaming of women.  Women want c-sections, and the poor doctors are just trying to what they can to please their customers.

Bull. Shit.

I don't see a doctor in that article talking about how many women would prefer NOT to risk surgical delivery, and how other doctors are making it all but impossible to deliver normally.

Dr. Alan Peaceman, chief of maternal fetal medicine at Northwestern Memorial Hospital in Chicago even has the guts to say “I don’t think anyone should be worried about it."

Oh, gee, thank you dear sir for essentially patting me on my pretty little head and telling me not to worry about your steel instruments gutting me like a fish, causing me intense long-lasting pain, and scarring me permanently.  Jag-weed.  You're the reason I hate doctors.  I'm also hugely grateful that I know how your hospital feels about these things so I don't make the mistake of delivering there, like so many of my fellow Chicago women who get roped in by the flat screen TVs and waterfront views your hospital boasts in its brochures.  Yes, Mr Peaceman, make sure you don't mention to would-be patients that you have no problem endangering their lives because you can't be bothered to "worry about" the compelling evidence that cesareans should be avoided if possible.  You, dear sir, should be ashamed of yourself.

Off to worry my pretty little head about some other things today.  Hmph.

Words I Never Thought I'd Say...

Should I just be grateful for my babies?

I was stumbling around the internets tonight, and found a blog that one of my friends subscribes to.  It's a woman who blogs about her infertility, and how she lost her baby to still birth one year ago this week.  He was nearly full term.  The story is heart-wrenching.  They tried and tried, and finally conceived. They imagined this perfect, beautiful baby for 36 weeks... and they got a perfect baby... just one without a heartbeat.  I think my greatest fear in all the world is to have to deliver a full-term dead baby, especially if you're induced knowing that you'll be delivering a still-born - not knowing WHY - just that the baby's heart had stopped some where along the way.  God, how can a person even function through that?  I'd rather lose my arms, legs, sight, and hearing.  I'd rather do anything else than ever experience that kind of grief.

I don't even know this woman, but I sat in front of the computer sobbing as I read her story.  And it's times like that I think I'm a wretched woman for even caring about how my babies come into the world.

Yes.  I know birth matters.  And my VBAC was the most important thing I've ever done.  But I'd almost trade my VBAC for that woman to have her baby with her right now.  No... not almost.  I think I really would.  I think I might elect to surgically deliver all the rest of my babies if it meant that that many other women wouldn't have to deliver dead ones.

I know I'll never get to make that kind of a trade.  And Yes - that c-section did horrible things to me.  But I read her story, and I just want to go curl my babies up next to my chest and cry.  I want to cry for her... and cry for my undeserving selfishness of having such two miraculous babies to her Zero.

Dear Jesus-or-whoever:  Life is unfair.

A Successful HBA2C!!!!

My cyber-friend went and had her baby last night while I was sleeping... in what appears to be a 5 or 6 hour labor from start to finish.  Pretty impressive for her first vaginal birth.

I want to tell her thank you!  Thank you for getting your HBAC and thank you for doing it after multiple cesareans!  I think this will really encourage other women who might be afraid of their own bodies.  I can only imagine the joy you're feeling right now!  What an accomplishment!

Congratulations Mama!

Songs About Cesarean

I'm a huge fan of the Dresden Dolls.  If you don't know who they are, then do yourself a favor: drop everything you're doing and skee-daddle yourself on over to their Myspace page you can listen to some songs.  I feel quite comfortable (and qualified) in saying that Amanda Palmer is a gift to our generation.  She bleeds, sweats, cries, and even menstruates musical genius.  I am certainly a more complete person for having been affected by her melodies and lyrics.

But this is not a Dresden Dolls review.  I want to talk about one song in particular of theirs called "Girl Anachronism."  It makes me wonder if a child, who turns into a thinking adult, would be impacted by their entry into the world, most specifically by their cesarean entry.  It could be a stretch, but certainly worth thinking about.  Does Amanda Palmer possess a certain sadness about her "accidental" entry into the world?  Only she knows for sure.  But, what do you think?

Girl Anachronism

"...i was taken out
before the labor pains set in and now
behold the world's worst accident
i am the girl anachronism..."

"...i was too precarious removed as a caesarian
behold the worlds worst accident
I AM THE GIRL ANACHRONISM..."

Homebirth is illegal in your state. What then?

I have to say, I'm getting a little sick of the self-righteous homebirth bloggers I see who just "can't understand" why a person wouldn't choose a home birth.  Hey, I'm with you... I WANT a homebirth - but live in a state where home birth is illegal and CPM's who perform them are subject to criminal prosectution.  So what am I supposed to do?  Some CNM's are legally allowed to attend homebirth, but almost none do, and especially not for a VBAC.  Having had a prior cesarean basically eliminates your chance to have a home birth in the state of IL.  I can only think of one CNM willing to do a home birth after cesarean, and she's so booked up that it's practically impossible to see her.  I emailed her months ago and still have not gotten a response.

So puh-lease... homebirth supporters... when you read my VBAC story and get all huffy about "why didn't you just stay home to have that baby?!?" ask yourself if that was even an option for me.  I'm quite sure that no homebirth midwife would advocate me going Unassisted, especially after a cesarean, so unless you plan to travel to IL to help me have my HBAC, spare me your self-righteous indignation.  Not everyone lives in a homebirth friendly state.  I'm under quite enough of my own pressure trying to figure out how the hell I can have another baby outside a hospital.  I could use only informative commentary, please.

TIME Magazine Article on the Risks of Cesarean

Hallelujah.  The mainstream media is starting to get it.

Go forth and read this article titled "The Trouble With Repeat Cesareans"

http://www.time.com/time/magazine/article/0,9171,1880665-2,00.html?iid=perma_share

Leave a comment on the article too.  We don't want the thread overrun with the "vbac is dangerous" crazies.

Our Little Natural Birth Bubble

The 'internets' scare me.  Before I found the natural birth/vbac blogosphere, I spent a lot of time feeling pretty bad about my cesarean depression - mostly because of other a-hole, clueless women on the web telling me that "it doesn't matter how they came out" nonsense.  But then I found one blogger, then another, then another, who totally validated my feelings.  Then I saw The Business of Being Born, and felt like there was an entire army of women out there who understood that c-sections are sucky, sucky things.  Then, I posted my birth story, and had tens of thousands of visitors to my little site.  I got dozens of chearleading comments on my blog, and saw hundreds of other comments left on blogs around the world that reposted my story.  Suddenly I realized this movement was so much bigger than I ever imagined it could possibly be. I've been comfortably living in this Natural Birth Advocacy bubble for many months now.

I've almost become spoiled, I guess, because every once in a while I'll stumble onto some blog and read posts from women who really, seriously do not get it.  I happened upon a post yesterday that criticized one of my cyber-BFFs for the very existence of her cesarean awareness site.  They called it "propaganda."  Yeah.... just like the grim facts about smoking are "propaganda." 

Facts... my friends are facts, and are not "propaganda."  Remember what Sen. Patrick Moynihan used to say: "Everyone is entitled to his own opinion, but not his own facts."  So true.

So I got to thinkin'.  How in the world do you inform women about the dangers of all these interventions and surgical procedures without making it seem like you're trying to scare them?  Or worse,trying to guilt them?

Anyone accused of trying to guilt a mom into doing something differently gets tarred and feathered with no jury trial here in our neopolitical 'Every-Mom-is-Doing-the-Best-She-Can' Land.  God forbid you are accused of that.

And why in the world are they scared of hearing about the risks of cesarean, but not scared of the actual procedure itself?  What is with this "kill the messenger" mentality?  To those women I say "You should really be mad at the guy/gal who cut you open.  Not the blogger who commits their time to trying to help women like you avoid harm."

I seems like this whole thing is a mine field.  Women need to know... but some of them don't want to know.  Do you write them off?  What if these women are like me - stubborn, yet convincable? 

It's a conundrum, I suppose.  Put the information out there on the web for any willing party to find, and you're bashed for promoting "propaganda" and hurting someone's feelings.  Don't put the information out there, and moms sign up for repeat C's because they say they just "didn't know." 

I guess this will always be a grey area, but that doesn't stop me from feeling like a protective older sister when I see my cyber-BFF's hard work getting trashed by some misinformed mom.

So, I think I'll stick to my little natural birth bubble where everything feels safer...and smarter.  If you have any good sites for me to read, send them along, because my days of internet exploration are on an indefinite hiatus.

NEW STUDY: Vaginal Delivery Better for Mommys

I found this on a suscription-based women's health and fertility website.  It's geared toward medpros, but anyone can sign up for free updates.  You can find all kinds of juicy evidence-based information on there.  Read on...

Vaginal deliveries associated with better postnatal quality of life

Source: (ORGYN.com) BMC Pregnancy and Childbirth 2009; Advance online publication

Comparing the quality of life in women after normal delivery and cesarean section.

MedWire News: A study suggests that vaginal delivery might lead to a better postnatal quality of life than cesarean delivery, especially with regards to physical health.

In their prospective, multicenter study, the researchers measured quality of life in 100 women (aged 20-40 years) using the Iranian version of the Short Form Health Survey (SF-36) at 6-8 and 12-14 weeks after delivery.

Behnaz Torkan (Khorasgan Azad University, Isfahan, Iran) and co-authors found that postnatal quality of life in both women with vaginal and cesarean deliveries was improved from the first to the second time period.

Women with vaginal deliveries had a better quality of life overall, with significant differences for vitality and mental health in at the first assessment, and for physical functioning in the subsequent evaluation (mean SF-36 scores = 62.9 vs 54.4, 75.1 vs 66.7, and 88.4 vs 81.5 for vaginal versus cesarean, respectively).

When the authors compared the mean score differences in time periods within each group, they found women with vaginal deliveries showed more improvements in general health (mean difference = 2.5 vs -4.0 for vaginal vs cesarean). Conversely, women with cesarean deliveries showed more improvements in vitality (-1.8 vs 9.9, respectively) .

“Although these differences disappeared in the second assessment, the findings indicate that in the short term vaginal delivery might be preventive of postnatal depression,” the researchers conclude.

They caution, however, that the study size was small and results should not be generalized.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Posted: 16 February 2009 - reprinted from Orgyn.com- subscribe to Orgyn.com for free and read the entire study.

Consumer Reports says Natural Is Better

Finally, mainstream American seems to be getting hip to the natural childbirth movement.  Consumer Reports recently published a full article titled "Maternity Care: High Tech vs High Touch."

I am loving this article.  Consumer Reports is a respected, autonomous body, and if people actually read this, I could see it making a difference.

Back to basics for safer childbirth
Too many doctors and hospitals are overusing high-tech procedures

When it's time to bring a new baby into the world, there's a lot to be said for letting nature take the lead. The normal, hormone-driven changes in the body that naturally occur during delivery can optimize infant health and encourage the easy establishment and continuation of breastfeeding and mother-baby attachment. Childbirth without technical intervention can succeed in leading to a good outcome for mother and child, according to a new report. (Take our maternity-care quiz to test your knowledge.)

"Evidence-Based Maternity Care: What It Is and What It Can Achieve," co-authored by Carol Sakala and Maureen P. Corry of the nonprofit Childbirth Connection analyzed hundreds of the most recent studies and systematic reviews of maternity care. The 70-page report was issued collaboratively by Childbirth Connection, the Reforming States Group (a voluntary association of state-level health policymakers), and Milbank Memorial Fund, and released on Oct. 8, 2008.

Overuse of high-tech measures

The report found that, in the U.S., too many healthy women with low-risk pregnancies are being routinely subjected to high-tech or invasive interventions that should be reserved for higher-risk pregnancies. Such measures include:

• Inducing labor. The percentage of women whose labor was induced more than doubled between 1990 and 2005
• Use of epidural painkillers, which might cause adverse effects, including rapid fetal heart rate and poor performance on newborn assessment tests
• Delivery by Caesarean section, which is estimated to account for one-third of all U.S births in 2008, will far exceed the World Health Organization's recommended national rate of 5 to 10 percent
• Electronic fetal monitoring, unnecessarily adding to delivery costs
• Rupturing membranes ("breaking the waters"), intending to hasten onset of labor
• Episiotomy, which is often unnecessary

In fact, the current style of maternity care is so procedure-intensive that 6 of the 15 most common hospital procedures used in the entire U.S. are related to childbirth. Although most childbearing women in this country are healthy and at low risk for childbirth complications, national surveys reveal that essentially all women who give birth in U.S. hospitals have high rates of use of complex interventions, with risks of adverse effects.

The reasons for this overuse might have more to do with profit and liability issues than with optimal care, the report points out. Hospitals and care providers can increase their insurance reimbursements by administering costly high-tech interventions rather than just watching, waiting, and shepherding the natural process of childbirth.

Convenience for health care workers and patients might be another factor. Naturally occurring labor is not limited to typical working hours. Evidence also shows that a disproportionate amount of tech-driven interventions like Caesarean sections occur during weekday "business hours," rather than at night, on weekends, or on holidays.

Underuse of high-touch, noninvasive measures

Many practices that have been proven effective and do little to no harm are underused in today's maternity care for healthy low-risk women. They include:

• Prenatal vitamins
• Use of midwife or family physician
• Continuous presence of a companion for the mother during labor
• Upright and side-lying positions during labor and delivery, which are associated with less severe pain than lying down on one's back
• Vaginal birth (VBAC) for most women who have had a previous Caesarean section
• Early mother-baby skin-to-skin contact

The study suggests that those and other low-cost, beneficial practices are not routinely practiced for several reasons, including limited scope for economic gain, lack of national standards to measure providers' performance, and a medical tradition that doesn't prioritize the measurement of adverse effects, or take them into account.

Source: http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/overview/maternity-care.htm

Fertility Treatments = High Risk Delivery?

Here's a question for you all.  Does conception by means of fertility treatments automatically label a pregnancy and delivery as "High Risk?"  I ask because I know someone desperately trying to concieve via IVF, and believes that her (hopeful) pregnancy will be high risk and that she will not qualify for a normal, vaginal delivery.

I have to say that I am no expert in the field of fertility treatments, or how they may translate into birth risk factors, but something doesn't sound right to me about that.  It seems to me that just because a woman needs some assistance with getting a pregnancy to occur, does not mean that pregnancy is doomed to be risky henceforce.  I suppose it may depend on the why the fertility treatments were necessitated to begin with.  This particular friend's treatments are for a failure to ovulate due to increase progesterone levels, and PCOS. 

Tell me, other natural birthy mamas, do fertility treatments rule out a homebirth?  Or even an unmedicated vaginal birth?  Are all IVF pregnancies "high risk?"