Forced C-Sect in the News

Since I am now at home on Maternity leave, getting ready to have this baby, my schedule is all out of sorts....so posting here has been on the back burner. My midwife "checked" me on Monday and said that I was dilated to a 4, which is good news, but that still doesn't tell me how long I will stay at a 4 and doesn't give any indication on when I will have this baby. I can tell you that yes, I am ready....and being at home just waiting is a "catch 22". Thank God for my helpers, the Hubs, Mother and Mother in Law....its very difficult being 9 months pregnant with an 18 month old....and I don't expect it to be significantly easier with a newborn or anything...I just want my body back, I'm tired of feeling like an achy tugboat.

I was watching CBS Morning News and they did a story on a woman who is suing a Hospital in New York for forcing her to have a C-Section......see people...this is what I'm worried about.  This is not acceptable.  You can see the video of her interview here or read below...

"A woman is suing a New York hospital, claiming she was given a cesarean section against her will, reports CBS News contributor Dr. Holly Phillips.

Rinat Dray, 35, is the mother of three boys. Her first two were delivered by C-section and resulted in difficult recoveries. So in 2011, she was determined to have her next baby naturally, through a procedure called "vaginal birth after cesarean," or VBAC. It carries risk but can be performed successfully. 

After several hours of labor, Dray's doctor pushed back. "He said, 'It doesn't matter if you're making good progress. I don't think it's going to be natural. I don't have all day for you,"' Dray said.
She said she felt he was being impatient as he continued to pressure her to have a C-section right away, warning her that her uterus would rupture and her baby was at risk.

"They pushed me into the operation. I was begging all the way, 'Don't do it, my baby is fine! Don't do it!"' Dray said. "His answer was just, 'Don't speak."'

Ultimately, Dray said she never gave consent when she was going into her C-section procedure.

Dray is suing the hospital and doctors, claiming negligence, malpractice and lack of informed consent.

Michael Bast, Dray's attorney, provided the doctor's handwritten note from her medical file, spelling out his concerns.

"The fetus is at risk for serious harm without the C-section, and for the mother, 'benefits ...outweigh risks,"' said a note in which a senior hospital staff signed off on the procedure.

Dray's attorney said the smoking gun for her case is also in the notes.

"I have decided to override her refusal to have a C-section," the doctor wrote.

"The mother has the right. It is morally wrong, it is medically wrong, it is always wrong to take a knife and stick it into a woman when she says no," Bast said.

Dray said she would like to grow her family of three boys, but she said giving birth scares her now.

"They forced me like that. It was very painful to be treated all this way," she said, adding that she felt like her rights were being taken away from her.

"I was treated less than an animal," Dray said.

Dray also said her bladder was damaged in the C-section delivery and she is seeking unspecified damages for that, as well."

 What a horrible experience.  Instead of providing a specific list of risks for this particular case, the Doctor uses a blanket excuse/ possible scare tactic of "The fetus is at risk for serious harm without the C-section, and for the mother, 'benefits ...outweigh risks,"'.....and I'm hungry and late for my lunch date.  My instinct sides with the Mom on this one...why?  Because I think, like the majority of us,  she is a good Mom who would not want to do anything to harm her child....Because she has 2 other children she has cared for and raised...she didn't appear to be a reckless parent.

According to the Mother the Doctor was being impatient, and hopefully she can prove that in court...I think Hospitals and Doctors will take notice and be more patient any Momma friendly...that's all we want anyway...

Here's a better post than I can give you

Most days I am really proud of my blog and really feel like Im finding such good and useful info to put out there into the world.....info that may or may not sway your decision on how you birth, but it will make you think.  

I and then I find someone who does it better.....way better.....

I quit

she wins the internet...

I really hate that saying...

but really, do yourself a favor and read all of it...it really is so good.

Here is the best post ever on your 

choices during birth....

She says eloquent stuff like....

"It is interesting to note that experienced moms were almost twice as likely as first time moms to plan a natural birth. Many women leave their first births dissatisfied or disappointed with their experience and hope for something different the second time around. My dream is for women to know all their options before ever giving birth, so they don’t have to struggle with the emotional and physical recovery of a negative experience."

But she doesnt talk about lightning bolts coming out of your whoo-ha, like I do....so there's that.

Some healthy stalking & Home birth

Home Birth is taking over the WORLD!!!! Haha, not really, but I was excited to see Channel 13 in Houston have positive story on Home Birth and show video of a water birth!!!

Its about a 2 1/2 min video of the newscast, clip of the birth and an interview with the mom- you can watch it Here!

Also, Maria Sotolongo was mentioned during the story and that she is doing a documentary of 10 homebirths...so then I went on an internet stalking spree to find out more about her & this! 

Well, it appears she has already filmed all of her homebirths and its a done deal...I was so ready to share my birthing face to the world, darn!  Its probably prettier in my own mind anyway...

Here is the trailer for her documentary, called Breathe.

So then I did a little more stalking research and she has a cool blog...she is expecting a baby boy next month as well, and its refreshing to read that she is having the same exact struggles as I am!  Moodiness, sleep deprivation due to getting up 1800 times to pee during the night....

She also has a really awesome post on why she chooses homebirth. I love reading other people's passion for home birth....

It made me think...isnt it funny that there are so many blogs and women (like myself) that are just "ate up" with all this birthing naturally at home stuff???? I mean there are a gajillion blogs about how beautiful and awesome it is and what a fulfilling experience it can be. There are great documentaries that are so educational...like The Business of Being Born.

I can tell you from my own experience, I do have this deep desire to spread the word myself and I really cant tell you why....seriously, why do I care what you do? It really annoys me! I wouldn't want someone trying to talk me into to having a hospital birth...but for some reason I really want you to consider, I mean really entertain and evaluate the idea of natural child birth and even birthing at home!

But at the same time I know several women who have had satisfying hospital births with the epidural and a cool Doctor, they were happy with their experience...but they dont have blogs specifically reaching out to women to go that route, why is that?

Its a phenomenon that baffles me....maybe it will pass when I birth out this kid.

Let me also add that I am not trying to say that if you give birth in a hospital & use pain meds you are doing it "wrong"...I am genuinely not trying to offend anyone...You do you, I do me.....I am just exploring & making fun of my own personal need to promote what I'm doing....  

Induction Survival Guide

I just love women!  Well, not like that, but I just think its wonderful the women who look out for one another...who look out for people they dont even know! Them's the good kind.

Cori Lynn Gentry is a Birth Bootcamp instructor in California who wrote an Induction Survival Guide...and it is so thorough!  Its very real and useful info.  

Its goes through: 

• The different ways of induction 
• several different scenarios that can happen 
• Tips on a positive induction experience

Most of you probably know I am not a believer in non-medically necessary induction, and if you think its not a big deal then I urge you to read THIS.  There are some very important things going on between you and your baby at the end of your pregnancy.

If you HAVE to be induced I think just knowing what you can expect brings a certain amount of comfort.....Isn't Cori AWESOME for writing this???

Read the Induction Survival Guide HERE

5k baby! (not the exercise kind)

Yesterday my blog reached over the 5,000 mark for all time hits...I think that is super cool for the short amount of time I've been blogging!  I hope one day I laugh at how "cute" it was that I was so excited to reach 5K, lol

What started out as an attempt to preserve and promote natural birth...ended up morphing into just me promoting the idea of wanting a better birth experience all the way around. I hope I have inspired women to have a voice in their birth and have provided some thought provoking topics and info that help with decisions you might face when having a baby.  

I really like where the blog has headed because the last thing I want is to contribute to the "Mommy Wars" over who's right and wrong...let alone make a Mother feel bad for the choice she made for the birth of her baby. 

The Fam & Da belly

Since starting this blog, it has opened a world of conversations with women when they run into me...telling me their birth stories and what they wished they had known and what they would have done different. They truly find value in what my goal is....to improve the stories of birth that women will share with each other in the future.  

Something that I do want to try to figure out how to improve, as well, is 99% of people's reaction upon hearing the words natural childbirth, midwife, home birth...They make a face...like a scrunched up face and then shake their head and wave their arms like they dont want to hear nothing about that... I really dont appreciate that, 9 times out of 10 when people see this conversation-starter-of-a-baby belly they start asking all kinds of questions,  Who is my Doctor?  What hospital am I going to go to? .... and then have THAT reaction to my answers...its just plain rude...I dont know how to avoid it though...I'm not going to lie just to make them more comfortable, maybe I will just slap them... I mean, I dont make a face when people talk about so-and-so scheduling their induction....even though I have opinions on that....

Back to what I was saying, lol....sorry about the tangent.
This blog has brought me a lot of joy and has made me very proud and I wanted to thank all of you who read it regularly and share it with others...Shout out to the readers in Germany as well, danke schön!!

I like to refer to my readers as the strong, silent type but I am hoping more and more of you feel comfortable commenting...sharing your take on the things I post. 

Some of my friends say leaving a comment looks confusing,  but here's how to do it....

You can either select Name or Anonymous from the drop down menu

Put your name, no url is required, but if you have a blog put it on there so I can check it out!

Click publish!

Success!

The opposite of Mother Friendly Care: When Birth is Traumatic

I literally copied and pasted this from the Midwife Thinking Blog...I hope that is legal? I gave credit so I assume I'm safe, anyone know? 

I also found this interesting...The Pregnant Patients Bill of Rights
Here is a very strong (Trying to find the right description...bold, graphic?) blog on Birth Abuse 

This is a guest post by Elizabeth Ford (website) who is based in the UK so is writing from a UK perspective. Elizabeth explored birth trauma for her PhD and generously agreed to write a post for MidwifeThinking. There are lots of references for students and/or those who like to access original sources of information.

Artwork by Amanda Greavette: http://amandagreavette.com

For most women, birth is not the blissful event of three easy pushes and welcoming their precious baby into the world. Even for those women who have a short straightforward vaginal birth, it can be a tough slog and a real test of the depth of their resources. However, for some women, birth is much more than that. It is a physical and psychological trauma. The aftermath of a traumatic birth can affect a woman for months or years and impact on her bond with her baby, her relationship with her partner, her decision to have another baby and even her willingness to engage with future health care.

Birth as a trauma

Childbirth is a common event in society so is viewed by most people as “normal”.  It may therefore be difficult to understand how it can be traumatic for some women. However, case studies and other research make it clear that women can suffer extreme distress as a consequence of their experiences during childbirth. A small proportion of pregnancies and births involve events that most people would agree are potentially traumatic, such as stillbirth, severe complications, or undergoing invasive medical interventions without effective pain relief.  Other women may have a seemingly normal birth but feel traumatized by aspects such as loss of control, loss of dignity, or the dismissive, hostile or negative attitudes of people around them.

Post-Traumatic Stress Disorder

Recently it has become recognised that women who experienced a traumatic birth can develop post-traumatic stress disorder (PTSD). Some women experience childbirth as threatening and frightening and go on to develop PTSD symptoms.

The American Psychiatric Association defines the symptoms of PTSD as (1):

1. Persistently reexperiencing the event, by flashbacks, nightmares, intrusive thoughts, and intense distress at reminders of the event.
2. Persistent avoidance of reminders of the event, and emotional numbing and estrangement from others
3. Persistent symptoms of increased arousal. This means difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance or an exaggerated startle response

For a diagnosis, patients must report experiencing all three types of symptoms for longer than one month. Many women (around 30%) experience these symptoms in the days or weeks following birth, and this is a normal way of coming to terms with a stressful or overwhelming event. It is only when symptoms do not get better that PTSD is diagnosed (in 1 to 5% of women).

What causes trauma & PTSD?

Research has been carried out into what makes someone more likely to develop PTSD following childbirth. These risk factors fall into three categories: those that exist before the birth; aspects of the birth itself; and the type of support and care women get after birth.

Some women will be more vulnerable to a traumatic birth because of pre-existing problems. For example women with a history of psychiatric problems and previous trauma are more likely to be traumatised by their experience of birth. In particular, a history of sexual trauma or abuse is associated with PTSD after birth. There is some evidence that women with a history of trauma will be more vulnerable to PTSD following birth if they have inadequate support and care during the birth (2-5).

During the birth, certain complications and events may be more stressful to women than others. Broadly speaking, women are more likely to get PTSD if they have an emergency caesarean or assisted delivery (forceps or ventouse). However, women who have a vaginal birth are still at risk (4, 6). Other stressful aspects of birth, such as blood loss, a long labour, a high level of pain, or a large number of interventions are not clearly related to getting PTSD. Importantly, women who feel out of control during birth or who have poor care and support from midwives and doctors are more likely to get PTSD (3, 5, 7). Furthermore, if a woman is overwhelmed by the experience and copes by dissociating (feeling like she is mentally “not there any more”, or having an “out of body experience”), she will be at higher risk of PTSD (8, 9).

Following the birth, support from friends and family, and possibly that from health professionals, may help women resolve their experiences and recover from a traumatic birth (5, 10). Conversely, a lack of support may prevent recovery or possibly cause more stress and thereby increase symptoms.

Feeling angry when birth is mismanaged

In some cases births are mismanaged and a woman can feel unable to get past her experience. She may go over and over the events in her head and feel angry that she was denied the experience she could potentially have had (11). This can form part of the symptoms of PTSD (intrusive thoughts, irritability & anger). However, PTSD is considered to be an anxiety disorder, and so for this anger and preoccupation to be diagnosed as PTSD, the other symptoms listed above must also be experienced. A woman who feels very angry is struggling with a valid emotional response to being discounted or not listened to during the birth, or even being mistreated or assaulted. Even when women don’t fit into the “PTSD box” (fulfilling all the symptom criteria), they may have a spectrum of subclinical trauma reactions which would benefit from support, counselling, or psychotherapy.

Is PTSD the same as postnatal depression?

PTSD has different symptoms to depression. Depression symptoms encompass a depressed mood i.e. feeling sad, empty, tearful or irritable, in addition to diminished interest or pleasure in activities; significant weight loss or weight gain or decrease or increase in appetite; insomnia or hypersomnia; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; and a diminished ability to think or concentrate, or indecisiveness.

In contrast, trauma symptoms are focussed on the traumatic event (re-experiencing it, avoiding reminders of it) and a diagnosis of PTSD is not possible without having experienced a traumatic event.  This is not the case with depression. However, in practice symptoms overlap and a majority of women who have PTSD will also have depression (3, 4).  Effective treatments for PTSD and depression differ. Recommended treatment for PTSD is psychotherapy, and only long-lasting or complex cases of PTSD benefit from anti-depressants.

Do women expect too much from childbirth?

A question that is often asked by health professionals is whether women have too high expectations of achieving a natural or drug-free birth, contributing to them being traumatised when birth does not go as expected. The answer to this is rather complicated but research studies point towards it not being the case. Firstly women’s expectations are found, on average, to be similar to their experiences (12, 13). That is, if a woman has broadly positive expectations she is more likely to have a positive experience. Secondly, if unrealistic expectations were linked to PTSD we might expect to find more trauma responses in first time mothers. This has been found, but subsequent analysis suggests it is due to the higher rate of intervention in these women (14). Finally, one study looked at this question directly and found that a difference between expectations and experience in the level of pain, length of labour, medical interventions and level of control was not associated with PTSD symptoms. However, a difference between expected support from health professionals and the level of care experienced was predictive of PTSD symptoms (13). Women don’t seem necessarily to be traumatised by the events of birth not happening as they expected, but may be affected when they do not receive the care they expect.

Implications for maternity care

Research in this field is at an early stage and more needs to be done before making policy recommendations. However, the body of evidence points towards several considerations. Firstly, some women enter pregnancy and birth with existing risk factors for PTSD, and these women may need particular care. Health professionals should be aware that women with a history of trauma, abuse (particularly sexual abuse) and psychiatric problems are at higher risk of PTSD following birth. There is some evidence that a lack of support during the birth may put these women at particular risk (5).

Secondly, interactions with other people have a strong effect on trauma reactions. For example, PTSD is more likely following events which are perceived to have been intentionally perpetrated rather than following accidents (15). This effect of personal relationships and care is particularly relevant to childbirth (16). There is substantial research showing support during labour and birth improves both physical and psychological outcomes (17), and that perceptions of inadequate support and care are predictive of traumatic stress responses. Women who are traumatised often describe negative interactions with staff such as feeling rushed, bullied, judged, ignored or put off when asking for pain relief.

Understanding the importance of support helps explain why, for example, level of pain is not consistently associated with PTSD symptoms. It may not be the level of pain per se which is traumatising for women, but the experience of unbearable pain in combination with the perception of being denied pain-relief by an uncooperative caregiver. Women also report caregivers proceeding with interventions, such as forceps deliveries or episiotomies, without consent, and sometimes even when the woman has clearly expressed her wish not to have the intervention. Negligent care such as leaving women naked in stirrups with the door open can be intensely degrading and stressful. Many of the traumatising aspects of childbirth could be reduced with consistent and considerate care from maternity staff.

What to do if this has happened to you

If you have had a traumatic birth and don’t know how to get help, the first step is to contact the Birth Trauma Association (BTA; www.birthtraumaassociation.org.uk) who give information and support. They produce a leaflet which you can print out and take to your GP explaining the condition (your GP may not have heard of postnatal PTSD), and you can ask for a referral to specialist psychotherapy services. If you’re in the UK, you can also contact the hospital where you gave birth and ask for a debriefing session with a midwife or consultant to go through your birth notes. This is not a counselling session but may help you to understand what happened during the birth and why events proceeded as they did. If you have physical problems following the birth you can also ask for a referral to a gynaecologist or physiotherapist. If you do not feel able to go back to the hospital where you gave birth, because memories are too painful or it causes you too much anxiety, you could ask your GP for a counselling referral or you could consider contacting a private psychotherapist. Make sure they are registered with the relevant professional association (BACP or BABCP in the UK). Recently in the UK you can “self-refer” to psychotherapy on the NHS through your local IAPT service (www.iapt.nhs.uk). Talking to other women who have been through similar experiences may help, the BTA can put you in touch with other mothers.

And Dads…

It can be traumatic watching a partner go through a harrowing experience while feeling helpless and horrified. The information on PTSD above can also apply to partners. The BTA has a section on their website for dads or partners. It is worth reading this and seeking help for yourself if you feel this applies to you.

More resources and support

I’ve added some links below (this is MidwifeThinking). Please let me know if you have any other links or resources that you think should be included.

• National Childbirth Trust (UK) - Position Statement and contact details
• Birth Crisis Network (UK) and article – Sheila Kitzinger
• AIMS (UK) – article and list of support networks
• Joyous Birth – Information, stories and links to support
• Birth Trauma Canada – support and information
• Trauma and Birth Stress (New Zealand) support and information
• Birth Stars (Canada) – support and information
• Solace for Mothers (US) – support and information

Blog posts about birth trauma:

• Mama Muse – Trust Love
• Navelgazing Midwife – Birth Abuse

References

1. APA. Diagnostic and Statistic Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington DC; 2000.
2. Wijma K, Soderquist J, Wijma B. Posttraumatic stress disorder after childbirth: A cross sectional study. Journal of Anxiety Disorders. 1997;11(6):587-97.
3. Czarnocka J, Slade P. Prevalence and predictors of post-traumatic stress symptoms following childbirth. British Journal of Clinical Psychology. 2000;39:35-51.
4. Ayers S, Harris R, Sawyer A, Parfitt Y, Ford E. Posttraumatic stress disorder after childbirth: Analysis of symptom presentation and sampling. Journal of Affective Disorders. 2009;119:200-4.
5. Ford E, Ayers S. Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms. Psychology and Health. in press.
6. Soet J, Brack G, Dilorio C. Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth. 2003;30:36-46.
7. Cigoli V, Gilli G, Saita E. Relational factors in psychopathological responses to childbirth. Journal of Psychosomatic Obstetrics and Gynecology. 2006 Jun;27(2):91-7.
8. Kennedy HP, MacDonald EL. “Altered consciousness” during childbirth: potential clues to post traumatic stress disorder? Journal of Midwifery & Women’s Health. 2002 2002/0;47(5):380-2.
9. Olde E, Van der Hart O, Kleber RJ, Van Son M, Wijnen HAA, Pop VJM. Peritraumatic Dissociation and Emotions as Predictors of PTSD Symptoms Following Childbirth. Journal of Trauma & Dissociation. 2005;6(3):125-42.
10. Soderquist J, Wijma B, Wijma K. The longitudinal course of post-traumatic stress after childbirth. Journal of Psychosomatic Obstetrics and Gynecology. 2006 Jun;27(2):113-9.
11. Brockington I. Postpartum Psychiatric Disorders. The Lancet. 2004 January 24;363:303-10.
12. Slade P, MacPherson S, Hume A, Maresh M. Expectations, experiences and satisfaction with labour. British Journal of Clinical Psychology. 1993;32:469-83.
13. Ayers S. Post-traumatic Stress Disorder Following Childbirth Unpublished Ph.D Thesis, University of London; 1999.
14. Soderquist J, Wijma K, Wijma B. Traumatic Stress after Childbirth: the role of obstetric variables. Journal of Psychosomatic Obstetrics and Gynecology. 2002;23:31-9.
15. Charuvastra A, Cloitre M. Social Bonds and Posttraumatic Stress Disorder. Annual Review of Psychology. 2008;59:301-28.
16. Ford E, Ayers S. Stressful events and support during birth: The effect on anxiety, mood and perceived control. Journal of Anxiety Disorders. 2009;23:260-8.
17. Hodnett ED, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews. 2003(3):Art No.: CD003766. DOI:10.1002/14651858.CD003766.

More on Mother Friendly Initiative

Why should you care? Because we're on each others team.... remember?
and you should care because I do! Haha, if only it were that easy to win people over to a cause. Maybe you had a wonderful birth in a hospital that went exactly the way you envisioned...I say good for you! That really is awesome!  But I have also talked to many women who have some deep emotional scars about how their birth went, saying they felt like they didn't have a voice, weren't consulted about the things going on with their birth...left in the dark so to say and then "required" a c-section and they weren't really sure why they needed one. I am working on getting these women to do a guest post for me but as you would think its a very sensitive subject for them, very emotional.  My heart hurts for these women....and from me to you- You are NOT a failure! The system failed you.  You should be able to go into any hospital to have a baby and trust that you will be catered to, cared for properly, respected, and consulted not instructed.  Sadly, a lot (not all) hospitals require you to be on the defense it seems.

If its not an important cause for you here's why I think it should be:

April 1st marks the beginning of Cesarean Awareness Month. "Our national cesarean rate of 1 in 3 women is a warning to us all. It’s not that providers should stop performing c-sections—it’s that they should stop pushing interventions and protocols that are known to lead to c-sections." -Cynthia Overgard

Visit http://pathwaystofamilywellness.org/Pregnancy-Birth/better-birthing-its-about-time.html to read "Better Birthing: It's About Time"

_________________

So right there it says 1 in 3 chance of a c-section if you go to a hospital, If we don't try to change something about the "system" in place what does that mean for your daughters and granddaughters? I know C-sections are not the end of the world, but at this rate will future generations even get a choice?

If you are curious about C-section rates by state, currently Texas (where I'm from) is pretty darn high at  35 %.  Louisiana has the highest rate at 40% and Utah the lowest at 22% according to the CDC.  Find out the Cesarean rate of each Hospital in Texas, (its the 2011 study so if your Hospital's name has changed since then it will be under the old name.)

If you plan to have a home birth your chance of needing a C-section is about 5.20% according to this study.  Maybe that's why after 37 years the highest percentage of home births occurred in 2012.  This is why the Mother Friendly Initiative is so important, there are a lot of women who would be more comfortable in a hospital setting but they don't want such a drastic increase in their chance of a c-section, and they don't want pressure to conform to all the hospital guidelines that aren't absolutely necessary.......

Here are 5 hospital procedures that aren't absolutely necessary (with legitimate sources)

I copied the info below from here

Here are the top five myths associated with hospital procedures that change your birth experience.

Myth 1: You need a monitor on your belly the whole time you're in labor.

Fact: You absolutely do not. Intermittent monitoring is shown to be just as effective, and actually allows the woman to focus on things other than her contractions. Consider that women are often made to lie down and stay relatively still with the monitors on as well, and you're put in a position where you have nothing to do but focus on and internalize any pain of contractions.

In fact, constant fetal monitoring often leads to unnecessary concern, and even intervention, including c-sections, so says the American Academy of Family Physicians, not some holistic home birth website, for those of you in doubt. In fact, only monitoring the baby's heart rate and your contractions every 30 minutes during early labor, and every 15 during transition and pushing is the current recommendation, but one that you almost never see actually practiced.

Myth 2: Lying on your back is a good position for pushing.

Fact: It sucks, big time. The only reason women end up on their backs is to make it easier for doctors to get in there. So, really, unless they NEED to be in there, it's a bad move. It's not only shown to reduce the size of the pelvis significantly, but it puts pressure on the vena cava, which reduces blood flow to the baby and your lower body -- why is it not okay during pregnancy, but they tell you to do it for hours on end during labor, and then are surprised at reduced blood flow to the baby?

The National Center for Biotechnology Information states that being upright, in addition to increasing blood flow also makes contractions and labor less painful, faster, easier, with a lot less trauma to the mother's birth canal, minimal to no tearing, and less trauma to the infant as well. It also makes for less postpartum complications, damage to the pelvic floor, incontinence, and in general, a much better, faster, less painful birth.

Also, if you opt for an epidural and can't feel your legs, you can't walk or kneel. So consider that you might not need that if you actually get up off the bed, and that just because you can't feel the pain with an epidural, your baby can, and you will once the drugs wear off. I wish I'd known as much about epidurals as I do now 15 months ago when I had my daughter. I was ashamed of myself for getting it then, but now I really, really wish I hadn't.

So why are 75 percent of births still done with the woman flat on her back? Back to the beginning of this point -- to make it easier for the doctor.

Myth 3: You can't eat or you'll barf it up and aspirate the vomit.

Fact: You wouldn't tell a marathon runner to skip breakfast, would you? Telling a woman about to engage in major physical work not to eat is almost as bad -- except what is at risk here isn't just a race, but two lives. Yes, there has been some concern that with intubation before anesthesia would come vomit, and then aspiration of said vomit.

MedScape discusses a study on the matter that says:

"Aspiration pneumonitis/pneumonia is significantly associated with intubation and ventilation," the study authors conclude. "In modern obstetric practice it is the use of regional anaesthesia, thereby avoiding intubation, rather [than] fasting regimens that is likely to have reduced mortality from aspiration. Although the National Institute for Health and Clinical Excellence has recommended, on the basis of consensus opinion, that women in normal labor may eat/drink in labor, our trial shows that this will not improve their obstetric and neonatal outcomes."

In other words, forcing women not to eat hasn't reduced aspiration -- not shoving tubes down their throats has. In their study, women who ate light meals showed absolutely no difference in anything -- no more vomiting, no more risk than women who were only allowed ice chips or water.

Myth 4: You need to be told when to push.

Fact: Do you need to be told when to poop? You no more need permission and direction to push out your baby than you do to push out a bowel movement. Just as your body uses contractions to move the baby towards the cervix and through it, it moves the baby down the birth canal, too. Your body will tell you what to do. You will feel when you need to push, and you will just work with it. When you feel the need to relax, do it. Push as hard as YOU are comfortable and if someone is yelling to you to push harder or longer than you feel you should, yell at them to shut up.

Pushing to the point of shaking, not breathing (called 'purple pushing' for the color your face turns) and breaking blood vessels in your face is not going to help you. In fact, it can cause the cervix to swell if you're not ready, it can make you exhausted, it can create much more severe tears, and is just a bad idea in general, even according to the World Health Organization.

Drugs can inhibit the feeling of needing to push (or the ability to know if you need to stop), though, but that's a whole 'nother topic all on it's own.

Myth 5: A break in contractions/labor stalling is a bad sign.

Fact: Women can get fully dilated and have the baby ready to go ... and then have a period that has been appropriately nicknamed the "Rest and Be Thankful" stage. It is nature's way of giving you a break after all the work to get your body ready, before the final hurrah. You can also have a break like this earlier in labor as well. Sometimes you can even be in early labor for what ends up being days, often called prodromal labor. We are mammals, first and foremost, and our bodies aren't stupid -- if a woman gets really stressed or really exhausted, often her body will sense that she doesn't have the energy for birth, or deems that it's an unsafe situation and halt labor until mom is rested or calmed. Think of a mother rabbit in labor realizing a predator is nearby -- she NEEDS to get safe before she can birth the babies.

Doctors often start up pitocin here, when the recommended things are anything but that -- squatting, moving around, getting in a bath all are proven safe methods to help the mother relax and get her contractions going in a normal pattern again. In fact, my midwife told me that studies show nipple stimulation and relaxing in water had been shown to be as effective, if not more so, than pitocin. Considering that pitocin is an artificial chemical designed to mock those from things like nipple contraction, it's not exactly a far leap in logic.

If your labor stalls, don't rush for the meds -- relax, move around, have a light meal for energy, try to take a nap. In and of it's own, it is NOT an emergency.

________

Tomorrow I will post responses from a question I asked to some Moms last week- Do you think its important to change the way childbirth is viewed and managed in the United States? Why or Why not? Looking for different views and opinions... If you would like to voice your opinion in this matter you can email your response to 1babybeborn@gmail.com, I would be happy to include your opinion (Even if it differs from mine, lol). ~Kellie

Guest Post Ashlea- Mother Friendly Care

From Kellie: Ashlea is Birth Boot Camp instructor I recently met and she is very knowledgeable about all things birth! She spoke a little about the Mother Friendly initiative and I knew this was something really important for us all to be aware of-  and for our (your) daughters and grand-daughters. For me, the basic premise of this movement is to reinstate the norm to be the natural process of birth and to use science when necessary- not let it completely take over (which it seems to be doing). I would like to see a day when all birth experiences/requests are accepted and welcomed in hospitals. I would like to eliminate pressure to conform to a certain type of care, and where Midwifes were just as accepted as OBGYNS..and covered by insurance.  Rant over? Not hardly, but this is a Guest post, lol, so I really should get to Mrs. Ashlea's post......

Mother-Friendly Care

When I was pregnant in 2013, I never considered researching a midwife or OB/GYN to find out if they were mother friendly. I assumed, insert play on words here, if they are caring for a pregnant woman, they must all be mother friendly.  Not the case at all!  It’s quite telling of an era when you actually have to seek out care-providers who are classified as “mother-friendly”.  Even more shocking, this has to be grounded in evidence based practices; they actually researched what benefited mothers throughout pregnancy and birth.  Naïve, pregnant me thought these were “duh!” moments, but this is not at all the case.  When you stop to reflect on where birth in our country has come from, it is totally amazing that the Coalition for Improving Maternity Services was founded. 

(photo reference: www.truthaboutnursing.org

In the 1900s, approximately 90% of all births took place in the home.  Hospitals were not widely assessable, and mothers were attended by both midwives and doctors.  But from 1910 and 1920, the midwifery model of care was tossed to the side as the medical model of care became prevalent.  Instead of focusing on the physical, psychological, and social well-being of a mother, the medical model is geared toward pathology (identifying what’s wrong) and diagnosing from patient symptoms. Childbirth was no longer considered a normal time in a woman’s life.  Dr. Joseph B. DeLee wrote and published an article in the American Association for Study and Prevention of Infant Mortality (1914-1915) where he (and others) discuss opposition to any movement to perpetuate the careers of midwives.  They are considered a “drag on (obstetric) progress as a science and art” are “not necessary at the present time” and “is a relic of barbarism”. As this field of obstetrics grew and the home birth midwife discredited, fear of childbirth and the pain associated with it helped encouraged women to birth in the hospital.  Today, 99% of U.S. women birth in the hospital (the majority with an obstetrician). 

Simultaneously, “twilight sleep” was introduced, and through a combination of morphine (pain medicine) and scopolamine (amnesiac), a laboring woman would have no memories of giving birth.  Considering this happens about the same time women are fighting for suffrage, it was widely welcomed among upper-class women. These unconscious women were strapped to beds, given a cut in their vagina (episiotomy), and their babies pulled out with forceps.  Today, only few women are unconscious for their births, but many of these practices carry over:

• ·         Laboring  flat on your back
• ·         Interventions to “speed” labor
• ·         Treating mother as the passenger in her birth rather than the driver 

As fewer births took place at home, women weren’t able to see what a natural birth is like from aunts, sisters, and friends.  Soon, women would labor without having ever seen a birth and this created the fear of the unknown. They would most likely not know that the body releases endorphins when a woman labors without drugs.  Naturally released oxytocin crosses the blood-brain barrier and causes the uterus to contract and the endorphins allow you to cope with these contractions.

Fast forward to the modern birth climate:

• ·         The U.S. cesarean rate is 36%.
• ·         The U.S. epidural rate is 76%. 
• ·         The U.S. maternal mortality rate is four times greater for African-American women than for Euro-American women.
• ·         The U.S. spends more money per capita on maternity and newborn care than any other country and falls far behind most industrialized countries in perinatal morbidity and mortality.

Holy cow! Well, as a result, the Coalition for Improving Maternity Services (CIMS) has set out to make a difference. Individuals and national organizations, who are concerned for the care and well-being of mothers, promote a wellness model of care to improve these outcomes (and save money).  I love that CIMS is a group of people working towards the same awesome goal: quality care for mamas and their babies.

There are 10 Steps of the Mother Friendly Childbirth Initiative for a hospital, birth center, or home-birth midwife to fulfill before receiving the CIMS distinction:

A mother-friendly hospital, birth center, or home birth service:

1. Offers all birthing mothers:
• Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends;
• Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula,* or labor-support professional;
• Access to professional midwifery care.
2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.
4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.
5. Has clearly defined policies and procedures for:
• collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
• linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.
6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:
• shaving;
• enemas;
• IVs (intravenous drip);
• withholding nourishment or water;
• early rupture of membranes*;
• electronic fetal monitoring;

other interventions are limited as follows:

• Has an induction* rate of 10% or less;†
• Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
• Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals;
• Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.
6. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
7. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.
8. Discourages non-religious circumcision of the newborn.
9. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:

1.      Have a written breastfeeding policy that is routinely communicated to all health care staff;

2.      Train all health care staff in skills necessary to implement this policy;

3.      Inform all pregnant women about the benefits and management of breastfeeding;

4.      Help mothers initiate breastfeeding within a half-hour of birth;

5.      Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;

6.      Give newborn infants no food or drink other than breast milk unless medically indicated;

7.      Practice rooming in: allow mothers and infants to remain together 24 hours a day;

8.      Encourage breastfeeding on demand;

9.      Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;

10.  Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

† This criterion is presently under review.

What can you do to ensure your location/provider is “mother friendly”? In my opinion, take a Birth Boot Camp class. Childbirth education is well worth your time and money.  We cover red flags of care providers and talk about how to be confident when choosing a birth location.  Ask some important questions regarding “standard” procedures: episiotomies, group B strep, pushing positions, and so many more. 

Your baby’s birth day will only happen once.  Carefully and thoughtfully consider your desires.  A mother friendly care provider will respect you, your wishes, and honor the sacredness of your special day.  ~Ashlea

Visit Ashlea's website
http://anindulgentbirth.com/