New picture I'm working on

I"m working on a couple of series of pictures, they're just in the first stage of development , but I wanted to get some opinions on this one- it's very controversial.

"Birth Rape" by Dani Arnold-McKenny 2010

Canadian Births: "where" is more important than ever

Canadian Births: "where" is more important than ever.  "Where" as in: where in Canada you are giving birth-
Almost one in four women in Newfoundland and Labrador deliver their babies by C-section, compared with only one in 20 in Nunavut. The percentage of women getting an epidural while in labour is three times higher in Quebec than in the Yukon, and there are 2 1/2 times as many “assisted births” (involving forceps or vacuum extraction) in Alberta than in Prince Edward Island. 

Isn't that strange?  That women who live on the East Coast of Canada have suddenly developed a problem giving birth vaginally?  Or that women in Quebec have strangely lost their ability to push their babies out without help of a vacuum or salad tongs?  How could this be?  Is it the water?  Maybe something in the air that they breathe?  Or could it be that doctors and hospitals in those areas are more scissor happy than in other areas of Canada? hmmmmmmm....

Personally I like the part of the article where the  SOGC, concerned by the increasing rate of cesarean sections, has launched a plan to reduce the incidence of unnecessary surgery, with mixed results.“We have some good guidelines but there is no money for implementation,” 
ARE they freakin' joking?!  No money to implement guidelines that will save hundreds of thousands of women from needless surgical deliveries, and save multitudes of babies from suffering respiratory distress and other life threatening problems due to the over used of medical interventions like epidurals, inductions and caesarean sections?!  No money to implement a set of guidelines that by lowering the surgical birth rate would effective cut the cost of giving birth by at least 50%?!?   HELLO!?  Is there a mathematician in the house?

*insert smiley banging head against a brick wall* 

Obstetrical interventions

Procedures for delivering babies vary markedly across Canada

New data show wide regional disparities in C-sections, epidurals and forceps deliveries

Almost one in four women in Newfoundland and Labrador deliver their babies by C-section, compared with only one in 20 in Nunavut, newly released data show.
Similarly, the percentage of women getting an epidural during delivery is three times higher in Quebec than in the Yukon, and there are 2 1/2 times as many “assisted births” (involving forceps or vacuum extraction) in Alberta than in Prince Edward Island.
These are just a few striking examples of how the medical procedures women are subjected to during childbirth vary markedly between regions.
“The bottom line is that there are a lot of obstetrical interventions in Canada,” said Gisela Becker, president of the Canadian Association of Midwives.
“As for the variations, there are a whole bunch of reasons,” she said.
Those reasons include everything from more women giving birth over the age of 40 through to the fragmentation of care, and from overcautious risk managers through to doctors with ingrained habits.
“It’s really hard to figure out what the correct rate of intervention should be,” said Dr. André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada.. “There are a lot of factors that come into play.”
What is certain, though, is that the variations that exist are too great and suggest some inadequacies in care, he said.
Dr. Lalonde noted that the SOGC, concerned by the increasing rate of cesarean sections, has launched a plan to reduce the incidence of unnecessary surgery, with mixed results.
“We have some good guidelines but there is no money for implementation,” he said.
There were about 374,000 hospital births in Canada last year, according to the Canadian Institute for Health Information.
Of those, 18.5 per cent were delivered by C-section and 81.5 per cent were vaginal births. The cesarean rate rose to 23.7 per cent among women over the age of 35.
Ms. Becker, a midwife in Fort Smith, NWT, said that while there are cases where surgery is required, the “World Health Organization says that a C-section rate over 15 per cent is not acceptable.”

HERE to read the entire article at the Globe & Mail

"You Can't Take the Effect and Make it the Cause"

This excellent article from Musings of a Montreal Doula- Mother Wit  is a beautiful Ode to the Doulas out there that struggle with negative comments and attitudes of Hospital and Maternity ward staff on an ongoing basis.  Mother Wit speaks openly about the prejudice that exists towards doulas in general and the difficulties that they encounter in the hospital settings where they are oh so valuable. 

Doulas are Goddesses gift to birthing mothers and their partners.  They are there to encourage, inspire, calm, and communicate.  They are not medical practitioners. They do not provide medical services in anyway.  But they are a vital part of Birthing naturally.

3Cheers for Doulas!!!!  You're AWSOME!

You Can't Take the Effect and Make it the Cause

Thursday, June 24, 2010

"You can't take the effect and make it the cause," is a saying I quite like, immortalized in a song by The White Stripes....

Doulas have been around since the beginning of time, doing our warm-fuzzy bit for birthing women and new moms. But in the last few decades, this role has become far more political. Now we are also called upon to be advocates. As the doula profession grows stronger and stronger as more and more women request our services, we are becoming more scrutinzed, criticized, and even ridiculed by many medical professionals, despite most of our clients' excellent outcomes, both clinical and experiential.

Consider this: our modern role developed BECAUSE loads of women weren't enjoying their obstetric experiences. Women were coming away from delivery rooms feeling confused and traumatized about what went down. You've all heard about Twilight Sleep and all babies being yanked out with forceps. It was the women who said, "We need to figure out whether this debilitating treatment of us in birth is actually needed! Were we not born capable of figuring most of this out on our own like those women we hear about who squat in fields? What's wrong with us that we need to be knocked out and cut and without our husbands?" And as the women looked for more gentleness in birth, their concerns being picked up and validated by compassionate medical people, they realized that in the throes of intense labour sensations, they may not have the power to communicate their worries, and were terrified of getting caught in a cascade of interventions they didn't need or want.

Wonderful people, such as Klaus and Kennel, noticed how much better women felt about themselves and their birth experiences when they decided to take another woman with them into the birthing room. Even just the presence of another woman contributed great things to the birth experience, never mind a female who also knew how to provide great emotional support, communication of the mother's needs (not decided for her BY the support person, but translated to the medical staff FOR her if the labouring woman couldn't speak herself), and soothing comfort measures. These researchers took the time to conduct some well known and well documented studies which confirmed their observations. Lo and behold, the presence of a non-medical, nurturing woman in the birthing room drastically reduces the need for medical interventions, as well as the desire for pain relief from labour sensations.

I can kind of imagine how medical people, who have busted their humps to get through the gruelling hell that is medical school, becoming skilled at diagnosing complications and executing amazing feats to spare mothers and babies from death, might scratch their heads and go, "Say what?" when a friendly woman NOT in scrubs asks them, because the labouring couple are clearly very focused on the work of dealing with huge contractions, "if it's not truly necessary to stay lying down, this lady would enjoy walking around to help soothe her labour pain. She would like to have a natural labour if this is how things work out, and being upright seems to help her a lot. Would this be okay with you?" If that doula/mother/partner team do all kinds of strange things together, like slow dance, everyone massaging and murmuring sweet nothings to the mom, who drapes herself in unfamiliar positions chanting oddities like "oooopen!" and even yelling out tension releasing expressions of pain that would fill the uninitiated with fear, you might feel extremely wary. If you as the doctor are simply not comfortable with these shenannigans, having learned a way of managing labour that you are secure with and within your knowledge base and experience keeps your patients safe, you might, if you're not actually impressed by the birth unfolding naturally, feel odd. You may feel usurped. You may feel resentful that the couple seemed to respond emotionally far better to the person with the strange smelling back of doula tricks than to you, who is the one ensuring their safety, for Pete's sake! You may feel downright angry that some chick with her essential oils and hippie talk of breathing away tension came into your delivery room and messed around with your sense of rightness, in your own place of work no less!

We get that. I think it would probably be quite a normal human reaction, considering the doctor is the one in the room who bears all the clinical responsibility. But the thing is, our strange ministrations to these women ALONG with excellent clinical care actually create more favourable outcomes, for doctors, mothers, babies, and partners (fathers or other mothers). Even if medical people want to look at doulas sideways, believing we are puppet masters who pull our clients' strings to make them carry out our evil plots of undermining medical authority, it's important to take a breath and get some perspective.

Doulas do NOT attempt to assume medical care of a client (decent, run of the mill doulas don't, anyway). It may seem like it to a doctor or nurse if a mom is being yelled at to get angry and PUSH while we're smiling at her silently, not joining that enthusiastic cheering squad. It might irk nurses to hear us say, "your body is amazing! It knows how to birth that baby. You know how to do this." Please know this is not a covert attempt to undermine anyone's medical authority, but to execute the wishes of the mother, made known to us in advance. She has spent her pregnancy reading up, figuring out how she wants things in her birthing environment if things go reasonably normally, and discussing those things with us. We open their eyes to other possibilities they may not have learned in their hospital based childbirth education classes, yes, but if a mom is not interested in something, we don't go there. If our clients have different ideas from what is typically done in a hospital, it is our job to lead them to resources that will help them make decisions about their care...we don't tell them what to do, we make sure they've informed themselves from several different sources, so as to better make choices for themselves from an empowered place. We absolutely encourage them to discuss their wishes with their caregivers. Then we support what they want. If their ideas are not sympatico with typical hospital protocols, it is important for medical people not to assume their patients are weak minded, malleable creatures whose minds were warped by the likes of doulas. Patients need more credit than that. In fact, that's probably why we're here, because even up to the latter part of the last century, birth practices were still pretty barbaric in many ways..and women became fed up....

  HERE to read the entire article by Mother Wit

"Dump the Jerk"

"Dump the Jerk"..... I have said these very same words so many times to so many women.  And I'm not talking about their husbands, boyfriends or significant others.  I'm talking about their doctors.

This article rings so true for so many women in so many situations in so many places, but rings clearest for pregnant women and their choice (or lack thereof) care givers for their births. Sarah writes about one woman's experience with her Obstetrician:

"I recently heard through the grapevine about a woman whose doctor had scheduled a c-section because of suspected big baby.  (She is of course weeks from her due date.)  But, when the doctors vacation plans changed he no longer needed to schedule the c-section, and told her as much..."

I have heard several versions of this type of story myself, and each time my response was the same: 
"Get the Hell out of there!!"

Women feel especially trapped once they get to 30 odd weeks and the true colours of their doctor start to show.  They feel like it's impossible to change now.  Where will they go?  Who will take them on?  What if they don't find someone else?  They have a right to be concerned, even frightened, about changing everything at the last minute, but nothing is as scary as a doctor who's punching a time clock and pushing every woman through the same mold.

I have encourage several women to change their care provided in the last few weeks of their pregnancies, and worked with them to help them find another Doctor- or even better, a midwife!!  It is possible.  Many of the midwives I know will take on a client in this kind of situation no matter how close to their due date, regardless of how busy or "booked" they are.

But you'll never know if you don't ask! ;>P

Read this article- and pass it on to every woman you know that's stuck in this situation.  Let them know that change is GOOD!!!

Dump The Jerk: Changing Care Providers Before it's too Late!!

The Jerk 

So- your friends have introduced you to this "great"guy.  He makes great money, has a nice car, big new house, good looking, all that seems important.  You get a little closer a little faster than you would have liked and now you feel stuck in the relationship.  As you get to know him better there are some things that really bother you about him.

You don't feel like he respects you at all.  Whenever you mention something that is important to you he just blows it off.  You have been wanting to go see a ballet for months and he just won't go- even though you go with him to countless monster truck shows.  All of your opinions he would just rather not hear, and if you voice them anyways he makes a rude comment about how you don't really know anything.   Sometimes he even scares you a little bit. 

But- he is a great guy on paper, and all your friends love him.  You have been going together for a few months now and it just feels like it would be too hard at this point to get out of the relationship.  You hate being rude and hurting somebody's feelings anyway.

Of course you have a crazy, opinionated friend.  She thinks a man should be respectful of you and what is important to you.  Her husband treats her well, but doesn't have all that fancy stuff.  She is actually happy in her relationship, unlike your friends.  She keeps telling you to dump the jerk before it is too late, and you are stuck with him forever.

Seriously! 

When we think about the above situation, it seems obvious right?  Get out- find somebody good that you actually like and who likes you and respects you.

How many times do we hear this same stupid excuse though about somebody's doctor?  "Oh, I am already 35 weeks, it is just too late to change."  Or maybe this one, "Well, my sister went to this doctor too and I didn't know who else to go with.  He is all right, and he tells me not to worry about anything."

It is not too late to change doctors until the cord has been cut.  Am I being clear enough?  We are talking about the birth of your baby.  This is one of life's BIG events.  It will change you.  I am going to say that again, because it is so important.  Birth will change you.  How do you want your birth to change you?  Do you want it to be full of regrets?  Do you want to feel like a passive participant on a crazy ride where somebody else is behind the steering wheel?  Or do you want your birth to be beautiful and empowering, like you hear it can be?

HERE to read the entire article

Canada's Rising Caesarean Section Rate

 A brilliant article that comes clean about Canada's rising Caesarean Section rates.  It doesn't white wash the statistics, it doesn't hide the TRUTH:  Caesarean sections cause more Caesarean sections!!!  And every medical intervention in labour and delivery causes an increased risk of "having to have" a C/Section. 

While the Society of Obstetricians and Gynecologists of Canadais finally realizing that the soaring rates of medical interventions- such as inductions, epidurals, and C/Sections- are having a detrimental effect of the health of our women and children, they have yet to address the worst problem:

The Doctors and the Hospitals themselves.

 The Society of Obstetricians and Gynecologists of Canada has made comments that the C/Section rate is too high, that inductions shouldn't be done so often, that Vaginal  breech births are healthier than C/section deliveries, and that VBAC births should be encouraged.... but that's all just whistling in the wind if the doctors and hospitals are adamantly turning their backs with their fingers in their ears singing "Lalalalalalala..."

It's all very wonderful that they are making these recommendations and statements, but that's not helping the mothers who are out there searching for a birthing attendant who will allow them to have a VBAC or to deliver their breech baby naturally/vaginally. 

And don't just blame the doctors- finding a supportive midwife can be equally difficult.  When I was pregnant with my second child back in 2002, I had three different Toronto midwifery groups turn me down point blank because I had had a previous Caesarean section.  The fact that it happened 10 years previously didn't matter even slightly.  When I was pregnant with my 4th child- having had 2 C/S's and one natural  HBAC (homebirth after C/S)- I had to search for MONTHS and had to beg and cajole to find a midwife to support my wishes to have another HBAC birth.  ...and my 5th child? after THREE Caesarean sections?!?  I was SHOCKED to hell and back when one lone midwifery group in a 100 km radius actually accepted me as a client.  But even then, while they took me on, they did so with a lot of trepidation and scepticism.

If I hadn't been so damn stubborn, (and knowledgable), I probably would of given up on trying to have a vaginal birth years ago and would now be sporting 5 uterine scars.

NOT a Healthy situation.

So yet again, as with just about everything worth having in life, we need to fight to achieve and support our Rights.  If women do not demand that hospitals/doctors/midwives accept their wishes to have a VBAC birth, then change will not happen, no matter how many "recommendations" the Society of Obstetricians and Gynecologists of Canada wants to make.

Worries surround Canada's rising C-section rate

 

 

By Sharon Kirkey, Canwest News Service

 

Dr. Jan Christilaw was in the operating room the day a routine incision was made into a young mother's abdomen to deliver her baby.
What happened next, Christilaw says, "is something we never want to see."
Normally, the placenta separates from the wall of the uterus after birth. It's lacy almost, and not like solid tissue. "You can take your hands and sort of scoop it up, it's like breaking cobwebs as you go," says Christilaw, an obstetrician and president of B.C. Women's Hospital and Health Centre in Vancouver.
But the placenta had eroded through the wall of the uterus, a condition known as placenta accreta. As soon as they stretched the opening of the uterus to deliver the baby, "the placenta started bleeding everywhere," Christilaw says.
They couldn't get the bleeding to stop. The woman was losing two cups of blood every 30 seconds.
"You get into this place where you think, OK, this is what I'm trained to do, I know exactly how to do this," Christilaw, who was a senior resident at the time, says. "You don't panic, but you're calling in everybody you can possibly get into the room." People had to squeeze the bags of blood, because the pump could not put it in fast enough.
The only way to stop the bleeding was an emergency hysterectomy. The woman was in the operating room for eight hours, and lost 15 litres of blood.
It used to be that obstetricians might only ever see one or two cases of placenta accreta in their practice lifetime. Although still rare, obstetricians across Canada say one of the most feared complications of pregnancy is increasing as a direct consequence of the nation's rising caesarean-section rate.
Virtually all placenta accretas occur in women who have had a previous C-section, and the risk increases with each additional surgical delivery. The placenta attaches to the old C-section scar. Scars don't have a proper blood supply to feed a placenta, so the it keeps burrowing into the uterus until it finds one, sometimes pushing through the uterus completely and into the bladder or other organs.
The condition can be detected by ultrasound, but not always. "You almost never see it in a woman who has not had a C-section," Christilaw says.
Today, about 28 per cent of babies born in Canada are delivered by caesarean. In 1969, Canada's rate was five per cent.
More than 78,000 caesarean sections were performed in Canada last year, making it the single most frequently performed surgery on Canadian women.
Ellen Hodnett wonders how so many C-sections could be justified.
"Women have stopped being able to give birth vaginally, in such numbers?" says the professor and Heather M. Reisman Chair in perinatal nursing research at the University of Toronto's Bloomberg Faculty of Nursing.
The World Health Organization says no more than 15 per cent of deliveries should be done by C-section.
"We don't know what the ideal rate is," says Dr. Mark Walker, a high-risk obstetrician at the Ottawa Hospital and senior scientist with the Ottawa Hospital Research Institute. "I think it's fair to assume it's lower than where we are now."
Walker says changing demographics — older first-time mothers, more multiple births from fertility treatments, more mothers with hypertension, diabetes, obesity and other health problems — are not enough to explain an almost doubling in the C-section rate since the early 1990s.
Neither is there evidence to support the idea that women are seeking C-sections on demand. Studies from Ontario suggest less than one per cent of caesareans are for "maternal request."
The Society of Obstetricians and Gynaecologists of Canada says the vast majority of caesareans are done for medically valid reasons. But there are concerns that too many are being ordered because labour isn't progressing quickly enough, and that thousands of "routine" interventions are now being done that increase the odds of a woman needing a surgical birth.
What's more, the number of women who give birth vaginally after a previous C-section is dropping dramatically, meaning more and more women are having repeat C-sections.
"The percentage of caesareans we're doing for repeats because we didn't do a trial of labour, those are the ones we need to be asking ourselves about," Walker says.
Dr. Michael Klein calls it the industrialization of childbirth, where, in today's risk-averse society, women in labour are being treated "as an accident waiting to happen" and where doing something is always better than doing nothing.
"Physicians and society have helped women basically believe that childbirth is no longer a natural phenomenon, but an opportunity for things to go wrong," says Klein, emeritus professor in the departments of family practice and pediatrics at the University of British Columbia.
"But the fundamental issue is, we aren't improving outcomes by doing more C-sections. For the first time in Canada, we are seeing the key indicators for mothers and babies going in the wrong direction."
Risks to babies range from accidental lacerations when the surgeon cuts into the uterus, to neonatal respiratory distress. Research suggests two times as many babies born via C-section will end up in an incubator with water on their lungs, or with serious respiratory problems compared to babies delivered vaginally, because a C-section interferes with the normal hormonal and physiological changes associated with labour that prepare a baby to take its first breath.
Risks to women include higher risks of hemorrhage requiring a hysterectomy, major infections including blood infections, wound infections and bladder infections, and blood clots in the lungs — and every C-section increases the risk for another.
"If you have a caesarean section for the first birth, the probability of having one the second time around is huge, because of the difficulty women have in getting a doctor to look after them once they have a uterine scar," Klein says.
The worry is that the scar will pull apart during labour, causing a uterine rupture.
"If you have a catastrophic rupture, you can get into big trouble," Christilaw says. "You can have a negative outcome for mom or baby. In severe situations, the baby can die or become damaged — but that's a very rare outcome."
Her hospital is encouraging more VBACs — vaginal births after caesarean — in carefully selected women. "In those women who attempt a VBAC, our success rate is well over 80 per cent."
But less than one in five women in Canada with a previous C-section delivered vaginally in 2007-08. Eighty-two per cent had a subsequent C-section.
Christilaw says the only thing preventing Canada from seeing "horrific" complication rates from C-sections is the fact women are not having as many babies as they once did.
"A C-section can be a life-saving manoeuvre for a mother or baby. Nobody is saying differently," she says. "What we're trying to say to people is, a C-section is not a benign thing. If you need one, that's different. But you should not be doing this unless you absolutely have to."
C-sections are frequently the end result of a cascade of interventions that often starts with inductions.
Tens of thousands of women in Canada have their labours artificially induced every year, often via intravenous infusion of artificial oxytocin. Oxytocin is naturally produced by the human body. It's what creates contractions in labour. Today in Canada, one in five women who gives birth in hospital is induced.
What doctors fear are stillbirths. But alarmed by the rising rates of inductions, the Society of Obstetricians and Gynecologists of Canada recently urged doctors not to consider an induction until a woman is at least one week past her due date.
Claudia Villeneuve says that women are getting induced "if they're two, three, four days overdue."
"Inductions are rampant," says Villeneuve, president of the International Cesarean Awareness Network of Canada. "You have a perfectly normal mom who comes in with a perfectly normal baby, and now you put these powerful drugs into her system to force labour to start."
The "humane" thing is to offer an epidural, she says. With an epidural, a woman can't feel pain in the lower half of her body. But epidurals slow labour, sometimes so much that labour stops. "Now you have to get this baby out," Villeneuve says. Two-thirds of first-time C-sections are done for "failure to progress."
Klein says epidurals are too often given before active labour is established.
"The majority of women today get their epidurals in the parking lot."
So the cascade continues: epidurals increase the use of electronic fetal monitoring, where electrodes are strapped to the woman's belly to monitor her baby's heart rate.
"It's hard to change positions when you have a fetal monitor on, and an epidural with its little things taped to your back, and an IV in your arm," Hodnett says. "Why would labour progress normally, if you're stuck in a labour bed with all this machinery on you?"
What's more, EFM is an imperfect technology. It detects subtle changes that can't be picked up by just listening to the baby's heartbeat after contractions, "and those subtle changes are often false positives," Klein says. "In other words, the fetus is OK, you just think it isn't OK."
Kayla Soares had been in mild labour at home for 24 hours when her contractions suddenly stopped. Doctors told the Edmonton mother she would have to be induced. She was three centimetres dilated when they started the oxytocin drip.
"It was the worst pain I've ever felt in the world," she remembers. "I wasn't having contractions at all and then they put me on the oxytocin and every half-hour they would boost it up, so the contractions were coming every minute, pretty much. It was like going from nothing to being in crazy, absolute labour, and in so much pain." Eleven hours later, she was still just three centimetres dilated. "That's when they said it was enough, and they were doing a C-section.
"I didn't want to do it. I was asking, could we just have more time?"
Three weeks later, she still couldn't get out of bed without help. Her incision had become infected. "It felt like I was ripping apart every time I moved. It was a pretty brutal recovery."
Soares had her second baby in June. "I was dead set on having a VBAC," a vaginal delivery after caesarean. "It was a fight, an uphill battle the whole time with doctors." One obstetrician asked her her shoe size. "She said that because I was a size five and smaller framed that I definitely was going to have another caesarean and that a VBAC wouldn't happen. She said that because I was a 'failure to progress' the first time I'll be a 'failure to progress again.'"
Two weeks before her daughter was born, Soares started going in and out of labour. "They had me convinced it was causing stress to the baby even though the tests said everything was fine. They had me convinced it was enough, because I was overdue and they said my incision was going to rupture," she says.
"They just kind of scared me into having another C-section."
skirkey@canwest.com

HERE to read the original article
 

Melissa gives us the hard truth and a reality check about birth in American (and don't be fooled- in Canada too).  She writes about two births- 
Having a baby in the ideal, family-friendly United States
And
Having a baby in the real United States

Reading the first half gave me a happy glow.  Reading the second half reduced me to tears.  Tears because I KNOW that this is the birth experience that most women in the US and Canada are having.  Tears for the babies that have been born into a cold world that bundles them up in harsh cloth, under glaring lights  and yanks them away from their other self, their lifeline, their whole world.

Is it a wonder that so few mothers breastfeed their babies for at least the first 6 months? The impact of birth plays a huge role in how a breastfeeding relationship is started and continues- for both baby and mother. 

est is being processed...

Melissa Bartick

Posted: April 14, 2010 12:15 AM

Peaceful Revolution: Motherhood and the $13 Billion Guilt

"....Birth number 1: Having a baby in the ideal, family-friendly United States:

You give birth with the help of a birth doula. She helps you avoid a c-section or vacuum assisted birth, which is why your hospital hired her. Your baby is wiped off, then put directly onto your chest, skin to skin, with his head between your breasts. The nurse puts a blanket around you both, and then your partner cuts the cord. The nurse evaluates his initial transition to life outside the womb as he rests on your chest. As you lay semi-reclining, happy and exhausted, your baby uses his arms and legs to crawl over to your breast and he starts nursing. You and your partner are left undisturbed for an hour to enjoy your new baby, who has now imprinted the proper breastfeeding behaviors thanks to this initial breastfeeding. You are then transported to your post-partum room with your baby on your chest. The nurse returns and weighs, measures, and examines your baby right there in your room. You are with him as she gives him his vitamin K shot and antibiotic eye ointment. Your baby is handed back to you, and again placed on your chest skin to skin. He stays in your room with you until you go home. From your prenatal class, you knew in advance to ask most of your visitors wait until you go home, so that you can get some rest, and you turn the ringer off your phone, so that no phone calls will wake you. Before you leave the hospital, your baby's routine heel-stick blood test is done while he is nursing, and you are amazed to see he doesn't cry at all. You are discharged with clear instructions around breastfeeding, and phone numbers to call if you need help. You are not given samples and "gifts" from a formula company...... Birth number 2: Having a baby in the real United States: Your give birth to a healthy baby, and you've never heard of a birth doula. The umbilical cord is clamped and cut before anyone can say, "It's a boy!" Immediately, your baby is whisked across the room to the warmer where Apgar scores are assigned, he's given a shot of Vitamin K, and antibiotic eye ointment is slathered in his eyes, clouding his vision. He's placed on a cold scale and weighed and measured. He is examined by his nurse, who takes him to a different room to do her evaluation. He is bathed, washing off his mother's scent. At last, he's professionally swaddled into a nice tight parcel and handed to you to hold, cradled sideways in your arms. He's not skin to skin, and he can't move his arms and legs to crawl to the breast. Before you know it, an hour has passed since his birth, and since he's missed the window of "alert time" after birth, he slips into a deep sleep without having spontaneously breastfeed. You attempt to interest him in the breast, but he is really too tired to try very hard. Because he's wrapped up and has been given a bath, he can't use his sense of touch and smell to crawl his way over to find your breast. You don't know enough to unwrap him and feed him immediately after birth, because your prenatal class didn't stress the importance of skin to skin contact during the first 3 days of life. That was all discussed in a separate breastfeeding class and you didn't really have time or money to take two classes. Just as you're getting to know your new bundle of joy, the staff decides to check his temperature and his blood sugar. His glucose level is 45 -- normal for a newborn, but low for an adult. His temperature is a little low, too -- all that time in the bath, the cold scale, the swaddling, and the time away from his mom's body heat has led to hypothermia. Hypothermia and hypoglycemia can be signs of a serious infection, so immediately he is taken from your arms down to the nursery, where he gets what's known as a sepsis evaluation. Lying under a warmer down the hall from you, he gets his blood drawn, and then is left in his bassinet in the nursery to be observed for a few hours so you can't spend time with him as you recover from giving birth. He gets a 2 ounce bottle of formula, most of which he vomits, since the stomach of a five-hour-old baby is no bigger than a teaspoon, the perfect size to digest the colostrum your breast secretes for him in the first few days. Finally, your baby's brought back to you, swaddled in a nice package. He's more alert, but never imprinted breastfeeding very well, and he's very stressed from all the day's events. He might be full from the formula he's given, and doesn't breastfeed well. He tries later in the day. The nurses try to help you, but it feels like they all give you different advice, much of it conflicting. Little do you know, their advice is based on their personal experiences rather than any scientific evidence because they haven't had much training in breastfeeding. You don't know what to believe. Finally, your baby goes to the nursery for the night "so you can sleep," and he is brought in for you to feed him. He doesn't like it in the nursery, so he cries, and you don't get much sleep either. You have some pain when he latches on, and you're told that's normal. You're so excited about his birth that you talk to everyone by phone, and lots of people come to visit. They pass him around. Maybe someone wants to give him a bottle, and you figure, ok, why not. He's chewing on his fist, but no one ever told you that means he's hungry, so you give him a hospital-issued pacifier to suck on instead of his hand. You don't know that giving formula and pacifiers in the hospital will undermine your efforts to breastfeed. It's surprising the nursing staff doesn't inform you of this, and you didn't learn it in your prenatal class. You're too embarrassed to feed him with everyone there. Finally, your guests leave, but by this time, your baby's frantic, and nursing doesn't go well as a result. Overnight, as he stays in the nursery, he gets weighed, and he's lost more weight than he should have. The doctor says it's because your milk isn't in yet, and recommends more bottles. He still sucks happily on a pacifier and sleeps in the nursery despite his alarming weight loss, and no one suggests that you nurse him more often, room in with him, get rid of the pacifier, or see a lactation consultant, all of which would help put him back on track with breastfeeding. An hour before you're due to go home, the lactation consultant comes in briefly to check on you, but because her department is so understaffed, she couldn't see you earlier when you needed it most, and she has little time to spend addressing your problems. On your way out, a nurse hands you a marketing bag from a brand-name formula company, complete with free samples of formula and information on breastfeeding that makes it sound a little hard and scary. She tells you if you have any questions, to just call your pediatrician. The first night at home, things don't go well. It's the middle of the night, and your baby won't stop crying when you try to breastfeed. You wonder if you should just give up. You reach for that ready-made bottle and his crying mercifully stops. The problem is solved, at least for now....."

 HERE to read the entire article

 

"Emotional Inpact of Cesareans"

Another brilliant article in Midwifery Today Magazine on the topic of the Risks of Cesarean sections- not just the physical, but the emotional trauma that haunts so many mothers after being under the knife.  I have had 3 C/Sections.  Each one was very different and at different points in my life.  Each one made me feel like a failure.  Each one left me feeling like my body was imperfect- unfeminine- that it couldn't do what it was suppose to do.  Each one left me with a stronger urge to fight for the rights of birthing women everywhere, to save as many women as possible from going through what I've gone through.

Sadly though, so many women do not listen.  So many women seem to think that the medical machine knows what's best for them and they allow themselves to sacrifice up every bit of their autonomy onto the alter of modern obstetrics.   I cringe every time I hear a pregnant woman say "my doctor knows what's best for me.  I'll do whatever s/he says".  And every time I hear a woman say "Well, I'm just going to book a C/Section...."  I want to scream at them  "You have NO IDEA what you're doing to yourself!!!"

It's frustrating.  Yet I still talk about the dangers of Medical interventions every chance I get, to every pregnant woman I meet- IRL and on-line. I might be snubbed by most, but I know that my soapboxing have saved many women from the knife and many babies from the cold medical machine.  So I'll keep on preaching.  Regardless of the ridicule and back stabbing.

Emotional Impact of Cesareans

by Pam Udy

© 2009 Midwifery Today, Inc. All rights reserved.

[Editor's note: This article first appeared in Midwifery Today Issue 89, Spring 2009.]

Every 30 seconds in the US, a cesarean is performed.(1) This overuse of cesarean surgery puts moms and babies at risk—not just physically, but emotionally. My intent with this article is to show the emotional impact that cesareans can have on the family. A cesarean can reach far beneath the bogus smile on mom‘s face. It can scar her heart, as well as her uterus.
A baby girl is born. She grows and begins menstruating. She becomes sexually active and becomes pregnant. She births her baby. She breastfeeds her baby. This is life—normal and natural, yet exciting and important. In the continuum of life, pregnancy, birth and the postpartum period are milestone events. These experiences profoundly affect women, babies, fathers and families. They have important and long-lasting effects on society.
When a woman gives birth, she has to reach down inside herself and give more than she thought she had. The limits of her existence are stretched. There is a moment when every woman thinks, “I can‘t do this.” If she is lucky, she has a midwife, a doula or her mom to whisper in her ear, “You are doing it.” As she does it, she becomes someone new: a mother. If the birthing process is skipped or occurs in a hostile situation, or if the interventions become overwhelming, she becomes a different mother than she would have been if she had only had a supportive, midwifery model of care.
The Mother-Friendly Childbirth Initiative of the Coalition for Improving Maternity Services asserts that: A woman‘s confidence and ability to give birth and to care for her baby are enhanced or diminished by every person who gives her care and by the environment in which she gives birth.(2)
To control and actively manage a woman‘s labor and delivery, modern obstetrical practice relies on conformity. A woman is “subject” to rules, restrictions and protocols enforced by nameless strangers. Physicians and the hospital staff have authority—there is an unbalance of power. Doctors know this and some use their power to persuade women to “make” decisions in the interests of the physicians; and if they can‘t, there are the courts. I say: You can only consent to that which you are capable of refusing. If you can‘t refuse the test, the drug, the procedure or the surgery, then you did not consent to it. This is coercion and it leads to disempowerment of women. Disempowerment as it pertains to pregnancy and birth is the exclusion of pregnant women from the decision-making process, leaving them without means of self-protection, limiting their birth choices and leaving them few, if any, options. This is detrimental to the growth a woman should experience during labor and birth.
Many women who have cesareans suffer in silence because society expects them to “just be happy about their baby.” Well-meaning family members say, “Be grateful; a hundred years ago you both would have died.” The farce begins. We paint a smile on and pretend it doesn‘t hurt.
How do we convey the experience of traumatic birth? My heart has broken a hundred times while listening to the stories of my International Cesarean Awareness Network (ICAN) sisters. How do I tell you of the depth of the pain? We have lost the societal norm of decent and respectful care during pregnancy, labor and birth in our hospitals. Moms and babies are paying a high price for unnecessary and inferior “care.” The March of Dimes says that one in eight babies is born premature, costing $26.2 billion dollars annually.(3) Prematurity is linked to cesareans.(4) Compared to 16 other countries with at least 100,000 births, the US ranked last in maternal mortality and third to last in perinatal mortality.(5) The response to these poor infant outcomes is a 50% increase in cesareans since 1996. The belief that more medical intervention is better, regardless of cost, isn‘t supported by research.
Research has shown that when we stray from evidence-based maternity care, we have a high degree of obstetric intervention that is associated with acute trauma symptoms.(6) I caution readers to remember that how a woman perceives the event, not the event itself, plays a vitally important role in whether she has trauma symptoms.
Women report experiences that fall into the following categories:

• A sense of loss: birth didn‘t turn out like expected, loss of the experience of participating in the birth experience, not being there when the baby enters the world
• Interrupted relationship with baby: feelings of detachment from her baby
• Altered identity: sense of failure, feminine identity altered; lowered confidence in her body
• Intimations of mortality: surgery gives “rise to fears about mortality”
• Feelings of violation: from surgery where the body boundaries are violated, feeling “mutilated” or “butchered”
• Anger at caregivers: particularly regarding “what was perceived to be an unnecessary cesarean, lack of involvement in medical decisions, feeling unsupported by hospital staff before, during and after the cesarean”
• Dissociation: feeling that the surgery was taking place on someone else or from a distance
• Humiliation: being scolded
• Helplessness: not being able to take care of herself or her baby
• Posttraumatic Stress Disorder symptoms: anxiety, trouble sleeping, panic attacks(7)

Caroline said, “I felt like I was up for sacrifice…I think I was sacrificed for the sake of my own stupidity…I think I sacrificed my soul. This sounds rather extreme, but so is the pain right now…. This was supposed to be the most wonderful day of my life—better than my wedding day—and for this reason, it was a devastating loss. It‘s funny that most people seem totally accepting of weddings and marriages gone awry, and how traumatic that can be, but a birth gone wrong? To most people there is no such thing. We are just lucky we are ’healthy‘.”(8)...

HERE to Read the entire article

"Cruelty in Maternity Wards"

Gloria Lemay writes about the original story published in the 1958 Ladies Home Journal blowing the whistle on the cruel and sadistic treatment that women were receiving in the Labour & Delivery hospital wards of the 1950's. The original article told horror stories of women being bound hand and foot, drugged and abandoned during labour for hours on end. Cruel and appalling treatment that women received from the doctors and nurses during birth that would rival many of today's scariest horror films.

Obstetrical professionals may be ashamed of the deplorable and heinous past of their profession, but will quickly point out that it's ancient history. But is it? Oh, no argument, the leather straps used to bind women's arms and legs to the labour bed have been removed and the "twilight" drugs used to silence and further immobilize them are no longer used, but the hard truth is that they have just been replaced with more insidious and underhanded methods of subduing and subjugating women.

The leather straps have been replaced with the elastic bands of the Electronic Foetal Monitoring system and IV lines. The "Twilight" drugs have been replaced with induction drugs and the epidural. The harsh cruel voices of Doctors and Nurses have been coated in silky words and velvet tones, yet still serve to undermine and control labouring mothers. Instead of dominating with force, they dominate with hospital policies, and the guise of concern and convenience.

"Now we'll get you an IV and the Pitocin drip to start your labour, and hook you up to the Foetal Monitor so that we can make sure your baby is reacting well to your labour. Once that is going, we'll get you an epidural so that you don't have to suffer through the pain of labour and can relax and rest...."

" We HAVE to do (insert a plethora of medical interventions here)- you want your baby to be safe and healthy right?"

.... Bonds of a different sort, yet just as controlling. The end result is the same. Women are still leaving the maternity ward feeling victimized and traumatized. Birth Rape is alive and well in the 21st Century.

March 10, 2010

Cruelty in Maternity Wards

From Sheila Stubbs, author of “Birthing the Easy Way”:

I bought a copy of a 1958 Ladies Home Journal on eBay last week. This magazine contains an article called Cruelty in Maternity Wards that had an enormous impact on women and began the movement to allow husbands into maternity wards.

A bit of history: An anonymous letter from someone who signed herself ‘Registered Nurse’ was published in which she begged the editor to ‘investigate the tortures that go on in modern delivery rooms.’ ‘You of the JOURNAL have long been a champion of women’s rights.’ she wrote, ‘[Exposing] this type of medical practice would go a long way to aid child-bearing women.’ What resulted from that letter was such a flood of letters from angry women that the JOURNAL did a full article revealing the reality of what women had experienced in hospitals. This was peppered with comments from an obstetrician who AGREED that the treatment had been cruel, and also comments from frustrated nurses who hated what they saw happening but would lose their jobs if they spoke up.

Here are some of the things women complained about in May 1958: ‘They give you drugs, whether you want them or not, and strap you down like an animal”. ‘’I've seen patients with no skin on their wrists from fighting the straps'’. “My baby arrived after I had lain on the table in delivery position nearly four hours.” When I asked why I couldn’t be put into a bed the nurse told me to quit bothering her so much. ‘’with leather cuffs strapped around my wrists and legs, I was left alone for nearly eight hours, until the actual delivery'’ My doctor had not arrived and the nurses held my legs together. She was born while he was washing his hands. I do not believe the treatment I received was intentionally cruel - just hospital routine’.

From a nurse: So often a delivery seems to be ‘job-centered’ - that is, get the job done the easiest, quickest way possible with no thought to the patient’s feelings. In too many cases doctors and nurses lose sight of their primary concern - the patient. ‘’I remember screaming… [the nurse] ignored me. … the doctor said at one point, ‘Stop your crying at me. I’m not the one who made you pregnant!’ My third baby will be born at home, despite the sterile advantages of a hospital confinement; for I feel the accompanying emotional disadvantages are just not worth it.”

From a nurse: ‘I have heard such unthinking remarks as ‘You had your fun, now you can suffer’ made by a nurse to a mother in great distress, damaging the spiritual nature of the childbirth experience and showing the nurse’s ignorance of the sacramental nature of sex in marriage.'’ “I reached the point where I wouldn’t have been surprised if the man who was washing the windows had suddenly laid down his sponge and come over to ‘take a peek.’ It seemed that everyone else connected with the hospital was doing it!” “I know of many instances of cruelty, stupidity and harm done to mothers by obstetricians who are callous or completely indifferent to the welfare of their patients. …Obstetricians today are businessmen who run baby factories. Modern painkillers and methods are used for the convenience of the doctor, not to spare the mother. There is so much that can be done to make childbirth the easy natural thing it should be, but most of the time the mother is terrified, unhappy, and foiled in every attempt to follow her own wishes about having the baby or breast feeding…”

Doesn’t that sound like it could have been written TODAY instead of FIFTY TWO YEARS AGO!! What do you say they get a flood of letters TODAY, marking the 52nd anniversary of this article! Let’s tell them that we still see Cruelty in Maternity Wards, it’s just taken a different form!

their website: http://www.lhj.com/

Sheila Stubbs www.birthingtheeasyway.com

HERE to read Gloria's entire article and her letter to The Ladies Home Journal

Conspiracy of Labour: Electronic Foetal Monitoring

Call it a moment of clarity. Call it an abrupt insight. Call it a grand conspiracy theory (of which I have many.... but that's another- many other- rants). It hit me all at once while I was in labour with Kael last month, though I forgot about it until this week.

Now I'm not a doctor or a scientist, so I don't have any insider information on this- but if there is a logical reason that I'm missing, please feel free to let me in on the secret.

WHY are Electronic Foetal Monitors (EFM) so ridiculously cumbersome and antiquated?

I was hooked up to one of those damn monitors when I was in labour almost 19 years ago with my eldest son- two palm sized clunky disks that have to be held against your pregnant contracting belly by two stretchy elastic belts and hooked up to a tangle of wires that lead to a metal box covered with dials and switches that pukes out a continuous strip of graph paper. (and possibly goes "ping"). I remember even back then thinking "this is ridiculous!!". Imagine my surprise when I went into the hospital last month while in labour with my youngest son only to discover that they had the same monitor!! I Swear!! It was exactly the same! Still ridiculously uncomfortable and stupidly designed...

Why?

No, really: WHY?!

Think about it:

-19 years ago Cellular phones were the size of tissue boxes. Now they are so small that they get lost in your pocket

-19 years ago Computers were monstrosities with 300MB of memory. Now we have cell phones that have 32GBs and still can get lost in your pocket. Hell! You can go to your corner electronics shop and buy a 1 TB external hard drive for less than you paid for a Sony Diskman back in 1991!!

-19 years ago if you got lost while out driving you had the choice of stopping and asking for directions or buying a map book the size of a small encyclopaedia. Now you have the choice of pressing the On Star button, or following the GPS on your dash board, punching the address into your GPS app. in your smartphone, or looking it up on Google maps on your laptop.

...Do you see where I'm going with this?

Technology in the last two decades has advanced in leaps and bounds in every industry known on this planet. So why has one of the most basic medical contraptions used in one of the busiest hospital departments has never even gotten a cosmetic make over, let alone a technological facelift? Even tongue depressors have been gussied up with flavours and colours!!

Here is where the conspiracy theory comes in. The only reason (that I can see) for the foetal monitoring system to of resisted any form of change is because.....

....Doctors and hospitals don't want it to change. Why would they? It completely works in their favour. Since science has already proven without a shadow of a doubt that EFM is not only NOT saving the lives of babies or mothers, and that it's actually causing more harm than good in 90% of labours, then we need to ask ourselves WHY it's still the regular procedure in every L&D ward in North America. Here are my thoughts on the subject.

Electronic Foetal Monitoring is used because:

- It keeps the labouring mother strapped to a bed. If she's tied up in a tangle of wires and straps, then she can't be wandering around the labour ward, can't be moving around to be comfortable and to assume positions that will ease her labour surges and facilitate an easier birth. No, it simply makes the lives of medical staff easier, by immobilizing the mother.

-If the mother is strapped to a bed and tied to this electronic monitor, then the hospital doesn't need to assign a nurse or birthing attendant to watch over her and take care of her and reassure her- why would they? They have the all powerful all omnipotent EFM there keeping track of every little bleep!

- If the mothers entire labour has been recorded on the EFM then the hospital and doctors have a permanent record of every second of the labour and something they can refer to in a court of law... that they can point to, to defend their need to interfere with medical interventions. The fact that these blips and bleeps can be interpreted anyway they want doesn't really matter... apparently.

- and of course the use of EFM makes lots of money for the medical machine!!! As the studies have shown for years, the more the EFM is routinely used, the more medical interventions are used, and the more interventions that are used, require the use of even further interventions to support and remedy the problems caused by the first interventions to begin with...which all costs money... lots and lots of money.

Apparently some knowledgeable people agree with me.

Margaret Lent wrote in her article entitled: The Medical and Legal Risks of the Electronic Fetal Monitor- Journal article, Stanford Law Review, Vol. 51, 1999

"The story of electronic foetal heart monitoring (EFM) reveals the problems posed to physicians and patients by the hasty acceptance of relatively unproven devices and techniques. When EFM was introduced in the 1960s, enthusiastic advocates promised that by enabling the continuous, electronic monitoring of the fetal heart rate during labor and delivery, EFM would enable physicians to detect dangerous heart rate patterns and to intervene more promptly than with intermittent auscultation, the long-employed technique of periodically monitoring fetal heart rate with an obstetrical stethoscope. Thus, announced EFM proponents, the device would reduce rates of neonatal illness and death. Based on these promises, EFM became the predominant form of fetal heart monitoring by the mid- to late 1970s.(1) However, experts now conclude that these promises remain unfulfilled and that EFM is, at best, a "disappointing story."(2) In the twenty-five years of its almost ubiquitous use, no randomized controlled trial has demonstrated that electronic monitoring does a better job of saving babies or improving infant health than intermittent auscultation.(3) Moreover, studies indicate that the inaccuracy of the technique prompts unnecessary interventions and contributes to the nation's excessively high rate of cesarean delivery, a major surgical procedure which places mother and infant at greater risk of injury and death than noncesarean delivery.(4) Despite the increased risks, the device remains employed in nearly all American delivery rooms. Continued high use of EFM is often attributed to physician concerns about medical malpractice liability and professional inertia. As one EFM critic has observed: "[Doctors] talk about [abandoning EFM] at conferences and at [medical] rounds and listen intently and all of that, but it's not measurable in terms of changes in behavior. Everybody's waiting for the next person to get brave."(5)""

And one of my personal heroes, Dr. Marsden Wagner- former Director of Women & Childrens Health for the World Health Organization (WHO) writes this in his article "Technology in Birth: First Do No Harm"

"There are other cascades of interventions during labour. For example, routine electronic foetal monitoring leads to more caesarean sections, which lead to babies with respiratory distress syndrome or prematurity, which leads to putting these babies into newborn intensive care units. Every one of these interventions carries risks for mother and baby! It is easy to see how the high-tec approach to birth actually creates many new problems. Rather than change their habits, however, doctors conclude that birth is quite risky, when in reality doctors have caused it to be risky....Doctors' fear of litigation is another non-medical motivation for using technology. Doctors are afraid both of having to go to court and of having to pay higher malpractice insurance premiums. Two prime examples of the unnecessary use of technology due to doctors' fear of litigation are routine electronic foetal monitoring during normal labour and caesarean section with little or no medical justification."

So, why would they change it? Why would they create a better, more reliable, less dangerous way of monitoring babies and labouring mothers? If they did, they'd loose. If they did, then maybe the public would realized that they have been duped for years and years and MAYBE the same public would demand an accounting of all the problems the medical machine has caused with their ridiculous toy. Better to stick to their guns and pretend that the problem doesn't exist. Besides.... who's going to question the all powerful all mighty medical machine? I mean, they only have our best interests at heart, right?