My experiences giving birth

I wrote up Erik's birth story for a natural child birth blog if anyone is interested they can check it out there...

http://naturalchildbirthstories.com/eriks-birth/

It's a nice blog, check out their photo gallery, such lovely photos:

http://naturalchildbirthstories.com/gallery/

Your right to bodily integrity? Not at this hospital!

A recent newspaper article from the Lake Powell Chronicle reports about a hospital in Page, Arizona has told a local woman that they will not allow her to give birth vaginally in their hospital. The hospital has a policy against vaginal births after caesarean sections (VBACs), and have said that they will get a court order requiring the woman to have surgery if she won't consent to it.

This situation is outrageous, but unfortunately it happens every day in America. Most women just don't get as vocal about it as this woman has.

There are thousands of hospitals in the US that have policies against allowing VBACs. Many are rural hospitals like this one where the woman's only other option is to travel hundreds of miles to give birth. This isn't about safety really, it is about liability and the risk that the hospital will be sued. This mother is no more likely to need emergency services than any other woman giving birth, the medical community is just terrified of VBAC and would rather do a c-section. They don't care that the medical risks to the mother are higher with major surgery, they only care that their risk of being sued is lower. It is another case of money being more important than patient health or autonomy.

Canadian Study

A new Canadian study isn't as large as the study just released from the Netherlands, but it backs up the point that home birth is a very safe choice.

The studied matched three populations; two giving birth under the care of midwives at home, one group birthing in the hospital with the same midwives providing the care and the third group being cared for by physicians in the hospital. I thought it was interesting that even though the women were cared for by the same midwives the infant mortality rates and outcomes were improved for the women giving birth at home. I think this is explained by the psychological benefits that come from laboring in our own safe, comfortable and familiar home environments. Psychological well-being during labor = a safer, smoother labor. It could also be that with the technology of the hospital in close proximity the midwives were choosing to use medical interventions more often than they did at home, and that affected the outcomes negatively.

Either way the outcomes for moms and babies at home were excellent, less hemorrhaging and tearing for moms, less trauma and need for rescucitation for babies (compared to their hospital counterparts.)

It is also interesting to note that both groups cared for by the midwives, whether at home or in the hospital, did better than the group of women cared for by physicians. The physician/hospital group had a higher mortality rate, higher risk of needing rescuscitation or oxygen therapy, and higher risk of trauma and meconium aspiration.

Here is a link to an article about the study.

PDF with the details of the study can be found here.

Public perception of home birth

I thought this story from Ohio was a good reminder of why midwifery and home birth advocates need to speak out about their birth choices and educate the public about the safety of out-of-hospital births. This situation would never have happened in a country like the Netherlands where birthing at home is considered a normal way to give birth and police officers would never think that the couple was endangering their child by making that choice.

A family in the Dayton area is entangled in a criminal prosecution as a result of their homebirth. Nine weeks ago, the Levier family welcomed the second child to the world at home with the assistance of a midwife. He was born safe and sound. A few hours later, they were a bit concerned about mom so they made the decision to call 911 just to be safe.

In Montgomery County, whenever 911 is called and a child is involved, the police show up as well. The EMTs insisted that the newborn baby needed immediate medical attention (despite being perfectly happy and healthy) so mom and baby transported in the ambulance and baby was monitored for a while to confirm his good health. Meanwhile the police further investigated, taking statements from Dad and the midwife, who identified herself as a doula.

Six weeks later, the Levier family was given asummons to appear in court regarding charges of child endangerment. Both parents have been charged and arraigned. The next legal step is in late September. Their attorney hopes to have the charges dismissed, but in the meantime, they are facing the expenses of attorney’s fees for representing BOTH of them while dad’s work schedule has been drastically reduced for September.

...Read the rest of the blog entry from the Ohio Familes for Safe Birth at their blog. This family needs help with their legal expenses...

Tribute from a midwife

My dear friend and mentor Jules Johnstun created this video montage in celebration of the women she has served as a midwife.

Isn't that just so lovely! I had the honor of being present at some of these births. These women are amazing, strong and beautiful. I'm grateful that they are willing to share their pictures and their birthing experiences with me. I'm also grateful for midwives like Jules that give so much of themselves to the women they serve!

Largest study to date on home birth

A very exciting new study was released last week in the Netherlands proving once again that 'planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women...'.   Because the study included over 500,000 women, the findings will satisfy the argument that home birth safety can't be proven because the prior studies have all been too small.  The entire study can be found at the following link:

http://www.cfpc.ca/local/user/files/{F249B8FE-6B6A-4426-BF21-57FA51A28796}/Home%20Birth%20Netherlands.pdf

There is a lot to be learned from the Dutch maternity system and the American system would likely have to be tweaked to accomodate the difference in American geography and culture.  The Dutch maternity system is completely integrated with the midwives providing primary care  and seamlessly working with doctors who provide the secondary care for higher risk situations.  In America, the home birth care providers are still very much separated from the hospital providers and because of our private/'for profit' medical system the two are direct competitors instead of allied partners.  The UK is already looking at this study as more motivation to continue the NHS' move to offering more home births, let's hope America someday follows suit.

Pondering Fear

I've had a number of conversations both online and in real life recently about why women and our society in general is so afraid of birth, and so convinced that it a horrific and painful experience that requires medication every single time.  (and I'm not trying to say that women should NEVER use medications, they are a fabulous tool in some situations, but they also have risks and repercussions that seem to be largely ignored).

I have been thinking that far too often it feels like by the time women are actually having babies their fears of giving birth are already so entrenched that it is difficult to undo.  As I talked about this to a friend lately I started thinking about a video I had seen recently, it was supposed to be funny, it was just a group of teenagers all facing a screen, the narrator tells us that they are in health class watching a birth video.  The girls are all screaming and covering their eyes, horrified at what they are watching.  I thought it was so sad.  I wondered what kind of video it was and how it portrayed birth and thought about what we watched in our health class.  I realized that often times birth is presented to teenagers as a deterrent to having sex (or at least to encourage them to use birth control) and is made out to be a painful, miserable experience.  I guess the hope is to motivate these girls to avoid pregnancy and the subsequent 'horrors' that come with childbirth.  I think these messages create fears that stick and then when women are ready to become mothers they go to great lengths to try and dissociate themselves from the horrors they expect with giving birth.  Usually just by having an epidural as soon as possible, but sometimes by insisting on a c-section or even avoiding having children altogether.

 

I know I felt this way before I had my first baby.  A man I worked with suggested that a home birth was a wonderful way to go and I told him that "I wasn't crazy, I was having an epidural"!  When I got the hospital and suffered through contractions lying on my back with no support and no clue how to help myself, my belief that birth is intolerably painful was confirmed.  Of course nobody suggested that I walk around, stand up, have a hot pack, any of the things that might have really helped, and I certainly didn't know how much my fear and tension was making it worse.  It took a lot of reading, several years, witnessing some births first hand, and finally the desperation to have a VBAC (and the conviction that I needed to be at home for it to happen) to really get me to accept birthing unmedicated.  Obviously when it turned out to be a completely comfortable experience (thanks self-hypnosis!) I was definitely convinced that birth is totally do-able, but it would have been tough to convince me of that 8 years ago.

 

So why was I so afraid and why are most of the women I know so afraid?  How is the information being presented in health class to high school kids and how can we convince educators to give kids a more balanced view?  (ironically, my own father was a health teacher for years, so I will be having this conversation with him for sure)  How we do we counteract all those crazy dramatic births that they show on TV and in the movies?  How can we 'infiltrate' the colleges and present the idea of birth being normal?

 

How can we get them to see this video:

 http://www.themidwife.net/index_files/Page340.htm 

instead of The Baby Story?

I wish I had the answers, sometimes it feels like it an impossible task to make birth a more 'treasured' experience in this country.  I feel like people put so much effort, time, though and preparation into their weddings, but do none of the above for the births.  How can people spend thousands for their weddings, but get bent out of shape at the idea that they might have to pay to give birth to their children?  They want and expect insurance to pay for all of it and are happy to let their insurance companies dictate which hospital they can go to and which provider they can see?  Would women accept the same situations at their weddings "sorry honey, but I'm paying for this wedding and this where your getting married and this is the person who is doing it".  I can't see a lot of brides being very happy about that situations why are prospective mothers okay with taking whatever is given to them for their births?

(okay now I realize this analogy is kind of bad because some people don't have fancy weddings and don't spend much money on that either - I am one of those people - but I'm speaking in generalizations here and on average Americans spend $20000 on their weddings.  Shocking to me, I got married in Las Vegas at  $50 chapel, but even people who don't spend anywhere near this much still spend easily a couple of grand out of pocket, but most people FREAK OUT at the idea of spending $2000 out of pocket for their births.  (oh and i'm talking Utah dollars here, double that if you live back East))

I would just really like to see women feeling as empowered about giving birth as they do about planning their weddings.  Brides do tons of research, they pay for a wedding planner to be their expert guides, read all the reviews, visit all the receptions centers, they OWN that wedding.  I want women to OWN their births too.  I want them to know all their options and be as excited about the idea that it is going to be a beautiful and positive day in their life, not just a day that they have to get through.

Apologies for this being a rambling post without much purpose, I'm digging through all these thoughts in my head and spewing them out into this blog hoping that somehow I'll be inspired about where to find answers.