Monday, August 31, 2009
Thursday, August 27, 2009
Friday, August 21, 2009
Listen to Obstetricians, Doulas, Neonatologists, Midwives, Psychologists, Pediatricians, and other Physicians explain how our health care system is failing babies and mothers and what we can do about it.
Thursday, August 13, 2009
Risk of selected postpartum infections after cesarean section compared with vaginal birth: A five-year cohort study of 32,468 women.
Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark.
To compare the risk of postpartum infections within 30 days after vaginal birth, emergency, or elective cesarean section (CS).
Register-based cohort study in Denmark. Participants. A total of 32,468 women giving birth in hospitals in the County of Aarhus, Denmark, during the period 2001-2005.
Data from various hospital registries were combined and infections were identified by positive cultures, prescriptions for antibiotics and, re-operative procedures. Risk of postpartum infection was estimated and adjustment for potentially confounders was performed.
Within 30 days postpartum, 7.6% of women who had underwent CS and 1.6% of women having a vaginal birth acquired an infection, yielding an adjusted odds ratio (OR) of 4.71, 95% confidence interval (CI): 4.08-5.43. The prevalence of postpartum urinary tract infection (UTI) was 2.8%, after CS and 1.5% after vaginal birth corresponding to an adjusted OR = 1.68, 95% CI: 1.38-2.03. The risk of UTI did not differ between emergency and elective CS. The prevalence of WI was 5.0% after CS and 0.08% after vaginal birth. Moreover, we found a nearly 50% higher risk of postpartum WI after emergency CS compared to elective CS (OR = 1.49, 95% CI: 1.13-1.97). More than 75% (697/907) of postpartum infections appeared after hospital discharge.
The risk of postpartum infection seems to be nearly five-fold increased after CS compared with vaginal birth. This may be of concern since the prevalence of CS is increasing.
Tuesday, August 11, 2009
But no. It said "pregnant". That little blastocyst turned embryo that had implanted in my uterus when I took that test exactly one year ago, is here with us, and has been for 3 1/2 months. It's crazy how fast the time flew by.
At the time, I so desperately wanted to get pregnant ASAP. But now that we have her, I am glad it took that long. We wouldn't have her. The one we were TTC all along.
This is how I feel lately. I hope it passes soon. I am really starting to resent being a SAHM. Maybe I am just not SAHM material. I never planned on being a SAHM for as long as I have (ohhhh, let's see, about 2 1/2 years now). I planned to SAH with Mason until he was about one, then go back to work, but with my menial jobs and constant nomadic lifestyle, it just didn't work out.
I am stuck. I can't go back to work because we cannot afford daycare where we live. The shitty secretarial jobs I get would not pay for daycare. Even if it did just cover daycare-I would be working just for someone else to watch my kids, and that's just fucking retarded.
I have no friends or family where we live--the closest is 1 hour away, but she works anyways. I have no friends where I live, and as the blog post states, when I left work to be a SAHM, I realized most of my friends were work friends. And I am not working anymore. We live in a car dependant area now and we only have one car at the moment. So no playdates either.
Here is the post:
I'm sure you've heard about The Study that was just released that evaluated a stay at home mom's workload and what these duties would be worth in the real world of employable skills.
$134,000 a year.
That would be your salary if you were doing all the things you do already (you know, those things no one ever notices unless they don't get done?) for a stranger instead of for those little people you birthed.
However, this study only looked at the menial labor.
For me, the hardest part of leaving a successful career and staying home was not the diapers, nursing, and cleaning.
It was the sobbing, loneliness, and sobriety.
I chose to have a baby at the worst possible time in my life - a period of two years where I had next to no friends. I quickly realized after four weeks of being home all day that my "friends" had all been work-related. This hadn't always been the case, but alot had recently changed in my life and my old friendships were practically non-existent and my work friends were, well, working.
To this day I'm not sure if I had post partum depression or not. I never had visions of harming my baby, but I did feel utterly despondent. Completely alone. Isolated.
I would fight tears from the moment I woke up in the morning until I went to bed at night. For. Two. Years.
My house was mostly clean. Dinner was always on the table. My baby was happy. See? Even if her mom was a bit manic.
Me, I was broken. I felt like I was screaming inside and no one could hear me. I would go to playgroups and the other moms sounded like Peanuts' parents. Wah-wah-wah. I was in a thick fog of confusion and sadness.
How much was that worth? How much was my sanity worth? My joy? My laughter?
How much would I have paid in those hours to get up, put on a suit, and walk out the door with my husband in the morning?
See, what sociologists will never get is that the physical tasks of mothering are not what make it so difficult and precious. It's not what we're doing. It's what we're not doing. And how we feel about that.
The "jobs" we perform pale in comparison to the heartache, guilt, and joy our pendulum swings between. And that's just before breakfast.
Here are the things you get a steady dose of at home that you cannot possibly compare to the office:
Guilt - When was the last time you cried yourself to sleep because you thought that spreadsheet didn't get enough attention today?
Loneliness - Could you ever go entire days at the office without talking to or even being seen by a single adult? Even when you wanted to?
Self Image - Did you ever detect smirks at a dinner party when you said you were Director of Operations or Manager of Sales? Probably not. You probably also didn't get this response: "All day? I don't know how you do it."
Thankless - How unexpected would it have been for you to go to the office every two hours throughout the night? Think that would've gotten you noticed?
Body Image - A long day at the office never produced vomit on your shirt and ginormous leaky breasts. And you probably never went into your boss' office and asked "Do you still find me attractive? Can you hold me?"
Pride - There's no promotions and no raises. You're sure to get fired in 18 years with no pension (unless he's going Ivy League). Yet, there is no greater responsibility than the one we have as mom.
There's so much more at stake with this new job. And we know it. That's our value.
Sweeping, mopping, dusting, coloring, vacuuming, cooking, scheduling, scrubbing, wiping, creating, driving, shopping, bathing, playing, tickling, talking, yelling, laughing, singing, reading, threatening, weeping, hugging, dancing : $134,000
Knowing you've gotten through another day without giving up: priceless
Thursday, August 6, 2009
I can't help but to feel a little jealous. I wanted that.
The Shoulder Dystocia was resolved. My daughter is alive and healthy, and I am so very grateful for that. But that doesn't stop the yearning for a non-traumatic entrance for my baby, and a peaceful birth for myself. I want that birth. Dammit, I don't care how petty, trivial or selfish that sounds to some. That's how I feel and there is no escaping it. I want it. Just once before I die, I want to experience birth that way. No trauma, no "Holy shit- I think my baby is dying!", no hospital, no rush, no panic....just my baby, my husband, me...and whoever else is there, enjoying the moment. I want to be the woman in that picture. I want my baby to come into this world without the help of a surgeon, a hospital, being yanked on for 4 minutes, or needing to be resuscitated.
But I am scared too. Scared of a repeat, but with a worse outcome. Part of me fears that having a third child, and at home, could spell disaster. I wish I didn't have to have these conflicting feelings. I wish the homebirth with Hannah would have went more smoothly. Now I have doubts that the next one would be better. I can just imagine now how I would feel when the baby was about to crown...if I would be thinking about another Dystocia or not. What Jason would be thinking, my midwife....or anyone that would be there. I don't want that tension present, but I know it would be there, hanging in the air, heavy and thick and inescapable.
I don't want another child just to "try again". I have always wanted three children. I still have that yearning, not only for another beautiful human being in my life, but to bring that child into our life with peace and without fear.
I don't think that's too much to ask.
Tuesday, August 4, 2009
Here is the full article. Below are some highlights.
The Society of Obstetricians and Gynaecologists of Canada
says 20 per cent fewer caesarean sections could be performed if doctors and
hospitals followed guidelines aimed at lowering unnecessary surgeries.
A recent survey of more
than 6,000 women in Canada who gave birth in 2006 or 2007 found 48 per cent said
they gave birth lying flat on their back.
More than half -- 57 per cent -- said their legs were in stirrups
when their baby was born.
Research has shown that women who labour in an upright position --
standing, crouching, propped up or sitting -- have shorter labours, and fewer
medical interventions, including C-sections.
Now about the study:
A double-sized foam mattress with large, comfortable
cushions was set up in the corner of the "ambient" labour room.
Sixty-two women were sent at random to either the ambient
labour room or a standard labour room at two Toronto teaching
In the end, women in the ambient labour room used
significantly less artificial oxytocin to speed up slow labours -- a 28 per cent
drop in infusions compared to women in the standard hospital rooms.
More than 65 per cent of the labouring women in the
ambient room, compared to 13 per cent in the standard labour room, reported they
spent less than half their hospital labour in bed.
Here is where the article lost me:
Two-thirds of first-time caesarean sections are done for
dystocia, "meaning labour isn't progressing as quickly as people would like,"
says Dr. Jan Christilaw, president of B.C. Women's Hospital and Health
But the tendency is to "bail out" when women are six or
seven centimetres dilated, "and that is the biggest group, people who are slowly
progressing in labour and people get impatient and bail out. It's a management
of labour thing."
The answer, she says, is to use
oxytocin. A soon to be published study by Ottawa researchers shows that
higher doses of oxytocin appear to increase the vaginal delivery rate without
Wait a minute. Oxytocin? Really? What happened with "they just want to bail out"? Isn't using Oxytocin considered "bailing out" too? Just because it isn't a cesarean section, doesn't mean it's not an intervention that may pose more risk than if it wasn't used at all. Sure, there may be women who really need that little "whiff" of Pitocin, but I don't think it's the answer for every woman that is starting to progress more slowly or stall at 6 or 7 cm.
The article talks about being upright to help labor progress, but the last time I checked, if you have Pitocin you are stuck to an IV. In bed. Not upright. I know some woman are "allowed" out of bed with Pitocin, but many aren't. I sure wasn't.
Dr. Christilaw says that a cesarean section done for failure to wait is a "management of labour thing." What is some Pitocin then? Is that not management of labor too? To speed things up to one's liking?
The article also says "higher doses of Oxytocin". Do they mean higher than usual doses of Pitocin, or just an overall higher amount of oxytocin in the body once Pitocin is added? I hope they mean the latter. Any 'high' does of Pitocin would scare the shit out of me, not to mention raise the risks even higher for uterine rupture (on unscarred uteri) and fetal distress.
I am curious to see this study when it comes out.