Making a difference, no matter how small

Today I had a phone interview with a reporter with The Daily Beast (It's an online current events publication based in NYC). She is writing about the cesarean epidemic, and the emotional toll it takes on women, and the growing backlash towards the current birth climate. She was awesome. We spoke for about a half hour. I can't wait to see the article - she said it should be out within the next week or two. I will definitely post it when it is available.

She had contacted me after she came across my site, BirthCut, while researching the topic. I can't say enough how proud I am of it. I am glad to see it is impacting people the way I had hoped. It has been so therapeutic to create, as well as receive responses from other women who are happy and relieved to find a site full of others who "get it", as well as validate their feelings as normal and not in the least bit crazy. I love receiving new birth stories, poems and art to post. I feel honored to do so. They are willing to share something so personal, so emotional... sharing some of these things, like poetry and art, can make you feel vulnerable. You are putting a big part of yourself out there, and you need thick skin. I also know how healing telling your birth story, creating art or poetry can be. It feels wonderful to play a part in their healing, and I will continue to help other women in any way I can.

Birth Trauma in babies

A very hard to watch video of the usual modern management of labor and birth. It shows the physical trauma (which probably leads to emotional trauma as well) that babies endure during delivery-mostly in a hospital setting, in bed, with feet in stirrups - and even cesarean section. The babies are being literally yanked on during delivery, causing spinal cord and brain stem injuries which in turn can cause respiratory depression and neurological disorders. Maybe chiropractic care should be a standard after delivery, especially after seeing this.

I knew some doctors and midwives "assisted" the delivery, but I never saw it to this extent. It is hard to watch without wincing. There is actually a part on the video where a woman is pushing (in the lithotomy position, of course) her baby's head out, and she asks her doctor if she should push. The doctor just continues to pull with force on the baby's head, and actually says,"We can do the work for you".

Reducing Infant Mortality

Reducing Infant Mortality from Debby Takikawa on Vimeo.

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.

http://www.reducinginfantmortality.com/

Risk of selected postpartum infections after cesarean section compared with vaginal birth: A five-year cohort study of 32,468 women.

Leth RA, Møller JK, Thomsen RW, Uldbjerg N, Nørgaard M.

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark.

Objectives
To compare the risk of postpartum infections within 30 days after vaginal birth, emergency, or elective cesarean section (CS).

Design
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.

Methods
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.

Results.
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.

Conclusions
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.

This time last year...

August 11th, 2008, after nearly one whole year of TTC, I peed on a stick and the word "pregnant" flashed across the result window. We had started TTC in September 2007, and we were one month off making the "infertile" mark. I was afraid we were going to make that milestone. I thought we would have to result to more invasive testing as to why it was taking so damn long.

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.

Excuse me while I bitch for a minute

I came across this blog post today from Cheeky Lotus that I could have written myself. I have not always felt this way, being a SAHM of one was still isolating at times, but it was much easier than it is now with two. And living in the fucking boonies doesn't help--we used to live in an in-town location with lots of other people around (a.k.a other kids and moms).

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:

Manic Momday

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

Jealousy

While reading some homebirth stories, I came upon a beautiful photo of a woman in the birthing pool, her partner right beside her, and she has her wet newborn, fresh from the womb pulled up to her chest....she just pulled her own baby out of the water. She is beaming. She looks radiantly beautiful. How wonderful for them...what a beautiful way to enter the world.

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.

"The answer is Oxytocin"?

I came across an article published in the Ottawa Citizen yesterday, about how having women upright in labor increases successful vaginal birth, and decreases cesarean sections. Professor Ellen Hodnett of University of Toronto's Bloomberg Faculty of Nursing completed a pilot study to see if small environmental changes (like taking out the bed) in a birthing room made any difference to the laboring woman. The article was great...up until they end.

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
hospitals.

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
Centre.

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
increasing risk.

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.